Neal Singh explains why healthcare organizations are turning to this strategy

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A family physician offers three case studies in virtual primary care

The New House Call?

In Our Podcast, Sundar Kamak Shares How Technology Can Help

Curing Supply Chain Woes

Lloyd Dean will retire as CEO of CommonSpirit Health in summer 2022. Dean has been one of the leading voices in the fight for health equity and during his 22 years, he contributed to the passage of the Affordable Care Act and partnered with the Obama administration to rally support for the bill.

Dean served as CEO of Dignity Health (previously Catholic Healthcare West) for 19 years before becoming CEO of CommonSpirit following Dignity Health’s merger with Catholic Health Initiatives in February 2019. The board has established a search committee to identify the next CEO.

Tom Hawkes has been named chief information and digital product officer at Caravan Health, a leader in accountable care. The role is newly created and Hawkes will continue in his role as head of product, infrastructure, and info-security.

Caravan Health’s clients are hospitals, health systems, and healthcare providers who partner with accountable care organizations.

Diversity and Inclusion Role Created at UVM Health Network

The University of Vermont Health Network has hired Jackie Hunter in the newly created role of chief diversity and inclusion officer. As part of the leadership team, Hunter will advance the network’s commitment to a more diverse, equitable and inclusive culture for employees, patients and communities.

Hunter most recently led diversity, equity and inclusion efforts with Banner Health in Arizona.

Victor Waters, MD, JD, FCLM, has been named the chief medical officer (CMO) for Dignity Health’s Arizona Central and West Valley Market. Waters has more than 30 years of clinical experience and approximately 20 years of administrative leadership experience.

Previously, he was CMO at Dignity Health St. Bernardine Medical Center in San Bernardino, Calif., and interim president and CEO of Nexus Fort Washington Medical Center.

Jefferson Health’s Klasko to Retire at End of Year

Stephen M. Klasko, MD, MBA, will retire as president and CEO of Jefferson Health, effective December 31, 2021, after eight years as president. He will remain a special advisor to the board of trustees.

Klasko was key during the 2017 merger of Thomas Jefferson University and Philadelphia University.

Articles

The CEOs at CommonSpirit Health and Jefferson Health are both retiring, the University of Vermont Health Network hires for newly created diversity and inclusion role and more.

MED MOVES: CEOs at Jefferson, CommonSpirit to Retire, New Diversity Role at UVM Health Network, and More

Hospitals and health systems are largely not equipped to handle all the patient data they could receive and turn it into actionable information, explained Edmondo Robinson, MD, MBA, MS, FACP, senior vice president and chief digital officer at Moffitt Cancer Center.

Oh, absolutely not they have they don't know what to do with those data. Especially we start talking about wearables, right? So, you think about it, a patient says, "Hey, I, I'm averaging 10 more steps this week than I was last week." What does that mean? You know, other than saying, "Yes, keep going. That's wonderful," it's hard to know what that means.

And so I think there's a process around structuring your approach to understanding, in this case, remote patient monitoring, wearable types of data, to say, are there criteria whereby a certain change — because it because some of those data are even continuous, right, continuous monitoring — so are the criteria whereby a change would trigger an intervention of some sort? Are there summaries? You know, a weekly summary, a monthly summary, whereby understanding those data at that level across over time is important for many intervention perspective. It depends by the data. And that's not even including all the research you want to do, which is going to ask the questions differently and attack them differently, depending on the  hypothesis being built in that particular research study.

So, you know, it could be everything from "I have a patient on a particular chemotherapeutic intervention; they're now at home after getting their infusion in the infusion center, and I want to monitor adverse drug reactions or events." Well, I could use wearables for that. But what does it mean, if the heart rate went up a little bit? Or if the heart rate went down a little bit? Is that a 88 [heart rate]? Or is that just normal variation in a heart rate?

You've got to set those parameters and you've got to understand what it means to have those data; but just looking at it constantly, it's not gonna be helpful. So, again, you really got to be disciplined about your approach to those data.

Will health systems and hospitals need to implement things they don't currently have, like artificial intelligence (AI) or different algorithms?

It could. That could absolutely accelerate your ability to sift through those data and get to...separate the signal from the noise, right? You absolutely could leverage machine learning to do that. You need a ton of data to train those models really well. But, ultimately, I think that's where it's going to go, whereby what happens is, the AI surfaces up, "hey, this, look at that, that's important."

But even short of that, you can just set some hard parameters around some of these things, right? Where, you know, they're not always perfect, but they at least signal that you should pay attention. So, for example, if your heart rates over 100 [bpm], I'm going to pay attention. Now, it could just be that you were out for a run — not a big deal. Or it could be that you are having some kind of reaction. And I'm thinking about even for patients who are on the inpatient side. It could be that I caused that high heart rate or I know the reason for their high heart rate. Or it could be that I don't know the reason. And I better go figure out what the reason is, right? So though that's just a hard, it's not even AI driven. That's just a hard line, that 100 right. So, there's some of that.

The reason why machine learning might be really critical is often it can pull signal from noise that we can't see normally. Right? And it might do it sooner. And that's actually really important.

Videos

Dr. Edmondo Robinson Outlines Hospital Readiness to Receive Large Amounts of Patient Data

John Figueroa is the chairman and chief executive officer of CarepathRx, a company providing innovative pharmacy solutions to hospital health systems. He also serves on the Pepperdine Graziadio Business School board.

“A gem cannot be polished without friction, nor a man perfected without trials.” This proverb from ancient Roman philosopher Lucius Seneca is a profound reminder for senior executives that excellence is born out of tribulation.

In a similar way, the COVID-19 pandemic has proven healthcare organizations, even in a crisis, need to tirelessly forge ahead with innovation to be successful. For CEO-level healthcare professionals and the organizations they serve, the current era of disruption is pushing healthcare into the future at a blistering pace.

Industry experts and healthcare futurists agree the pandemic has accelerated the need for organizations to innovate and adapt. Recently, management consulting firm 

., surveyed more than 100 healthcare leaders, from pharmaceutical and medical technology companies to health systems and payers. An astounding 90% responded that the pandemic will fundamentally change the way they do business, requiring new products, services, processes and business models.

At the heart of transformation are new technologies and innovative applications. While senior-level executives should not be expected to know every new application or upgrade, they need to follow the macro-trends. Here are five that will drive the industry forward:

Already healthcare executives are planning for a day in which care is based on specific, personal, genetic information versus physical exams, patient complaints or symptoms alone. Researchers are hard at work identifying ways to collect data that will one day enable highly tailored healthcare.

A catalytic event will take place in 2028, when the National Institutes of Health completes its 

research program, a historic effort to collect and study data from 1 million or more people living in the United States. As this research emerges, senior healthcare executives must be prepared to leverage its insights for maximum gain.

 The innovations and technology brought on by managing the COVID-19 pandemic has accelerated virtual care. The practice of telemedicine — once limited primarily to individual online consultations — has broadened to include coordinated and comprehensive virtual care. This convergence will continue to evolve to include data capture through wearables, video environments and post-acute monitoring. Senior-level executives should understand new capabilities, especially those powered by augmented information and artificial intelligence.

 Instead of making medications for diseases, drug makers will make treatments that work for the individual patient, taking specific needs into account. Data will also play a critical role in areas like clinical trials, in which several treatments are tested simultaneously and take place at home. This also extends to pharmacies where, according to pharmaceutical distributor 

, patients will benefit from smart drug packaging to improve adherence, digiceuticals to help patients with their drug therapies, point-of-care testing medical supplies and advances in equipment. In fact, services like these already exist at 

, for more than 80,000 chronically ill patients living at home.

COVID-19 dramatically increased the rate at which healthcare organizations moved information ecosystems to the cloud. In order to improve care, increase agility and protect data, healthcare providers shifted data centers to the cloud in droves — and there are no signs of that trend slowing. According to consulting firm Accenture, 

 say they will be operating within the cloud within the next year and 96% within three years. Senior healthcare executives don’t need to know the intricacies of cloud computing, but they do need to have trusted partners who can aid in adopting a cloud approach without compromising data.

 In the future, biotech companies will not be one organization, but a sum of multiple parts (like technology company Alphabet, the parent company of Google). Each company will operate separate units using a unified technology platform and mission. Innovative biotech companies will grow companies from scratch while making long-term investments in innovations and technology that enhances the entire organization. Senior executives will need to understand this new business model and how to fit in as a division, partner, or supplier.

To be sure, public health crises like COVID-19 are not the only frictions in healthcare. The push for expanded access to care, an escalating nationwide physician and nurse shortage and the unending call to bend the cost curve will continue to test the traditional limits of the U.S. healthcare system.

Disruptive technologies and innovation are already brightening the path to better medical outcomes. Indeed, the trend toward rapid innovation and transformation surges ahead. According to the Accenture study, 81% of senior healthcare executives say the pace of digital transformation for their organization is accelerating and 93% report their organization is innovating with an urgency and call to action this year.

As all these variables rub together with increasing force, the rough corners and faults will be polished out. A shimmering future lies ahead for those willing to keep pace with innovation.

John Figueroa is the chairman and chief executive officer of CarepathRx, a company providing innovative pharmacy solutions to hospital health systems. He also serves on the Pepperdine Graziadio Business School board and will moderate the 

The COVID-19 pandemic has proven healthcare organizations, even in a crisis, need to tirelessly forge ahead with innovation to be successful. Senior-level healthcare executives need to follow the macro-trends driving the industry forward.

Polishing the Stone: Healthcare Innovation and Technology

Despite the massive undertaking, both financially and structurally, that the US federal government took on to digitize the healthcare system by creating and nationally adopting electronic health records (EHRs), the promise of EHRs to significantly improve quality has remained tenuous.

One mechanism by which EHRs were expected to improve quality in particular was the implementation of computerized provider order entry (CPOE), coupled with clinical decision support (CDS) tools. CPOE enables healthcare providers to write orders for patients electronically, as opposed to verbal or written communication. CDS coupled with CPOE then uses EHR data specific to the patient as well as medication reference databases to supplement clinician decision-making and prevent potential adverse drug events, such as ordering a drug a patient may be allergic to or a drug with a potential contraindication.

While CDS tools intervene at the point of care, performance outcomes have been mixed and a significant amount of customization happens at the organization level which results in differences even within hospitals using the same technology.

A potential policy mechanism to incentivize quality improvement is public reporting of performance. However, recent evidence has cast doubt on whether national programs are useful tools in identifying high quality and it remains unclear if public reporting is an effective way to encourage improvement.

In order to determine whether publicly reported feedback was associated with hospital improvement in an evaluation of medication-related CDS safety performance, 

 authors conducted a nonrandomized controlled trial that included U.S. hospitals that participated in the CPOE Evaluation Tool in the Leapfrog Hospital Survey. This tool is a is a national quality reporting program that evaluates safety and performance of CDS using simulated orders and patients from 2017 to 2018.

A total of 1183 hospitals were included in the study with a mean CPOE score of 59.3% (16.3%) at baseline. Hospitals receiving negative feedback improved 8.44 percentage points more in the subsequent year compared with hospitals that received positive feedback on the same evaluation. This change was driven by differences in improvement in basic CDS capabilities rather than advanced CDS.

Overall, the authors found that publicly reported feedback was associated with quality improvement, which suggests that targeted measurement and reporting of process quality may be an effective policy that encourages improvement in specific areas.

Hospitals receiving publicly reported negative feedback improved their electronic health record medication safety.

Public Quality Reporting Associated With Quality Improvement in Hospitals 

On this week's episode of Data Book, Chief Healthcare Executive spoke with Tomer Shussman and Hila Glick of OneStep, a physical therapy app. We discussed the challenges with traditional physical therapy, how OneStep improves the proportion of patients who complete their therapy, as well as future uses for the technology being utilized in the app.

Podcasts

Tomer Shussman and Hila Glick of OneStep, a physical therapy app, discussed the challenges with traditional physical therapy, how OneStep improves the proportion of patients who complete their therapy, and more.

Podcast: Moving Healthier With the OneStep App

The results of a patient experience survey highlighted the need for healthcare providers to offer convenient communication options and user-friendly healthcare technology to improve experience and satisfaction.

The survey was conducted by Updox, a complete healthcare communication platform for in-person and virtual care. It was conducted online from August 31 to September 2, 2021, with responses from 2076 US adults ages 18 and older.

According to the survey, 53% of respondents said they would prefer to update or provide information such as health conditions, new prescriptions, or test results, digitally using online forms that can be accessed securely by phone, email, or patient portal.

In addition, 55% said convenient communications were among the most important factors when it comes to a good patient experience. User-friendly technology, such as an easy-to-use health portal or telehealth app, was the second-most important factor (51%), followed by secure information sharing (50%), and increased health safety (47%).

It’s clear that COVID-19 has impacted and even accelerated the expectations and preferences of patients and the ways they prefer to engage with and receive care from their healthcare provider,” Zach Zettler, president of Updox, said in a statement. “It is critical for practices to adjust to these needs to better connect with patients where they are - on their phones. When it comes to technology solutions that consumers believe are important for a healthcare provider to offer, it’s all digital.”

Common technology solutions patients expect to be offered included:

Patient reminders by phone call, email or text (65%)

However, 3% said no new technology solutions were important for healthcare providers to offer to patients.

The survey also evaluated new expectations of healthcare providers as a result of the pandemic. Requiring that masks be worn by both patients and providers during in-office visits was most expected (58%) followed by socially distanced waiting rooms (52%) and an option for online paperwork (42%). Only 41% and 39% expected telehealth appointment option and communications conducted virtually, respectively. Furthermore, 12% said their expectations of healthcare providers hadn’t changed as a result of the pandemic.

“Communication can truly be a huge barrier in getting healthcare services, which is why it’s so important for today’s providers to focus first on establishing relationships,” said Sherie Garrison, RN, Luke Project 52 Clinic. “At my clinic, Updox really is the glue we use to build trust with our patients. Texting with them isn’t always medically related — it’s a way to show we care about them, and we’re connected to them.”

Patients expect more convenient communication options and user-friendly technology from healthcare providers now.

Patients Expect Providers to Offer Convenient Communication, User-Friendly Technologies

Telehealth isn't the only enduring technology that was implemented during the COVID-19 pandemic; artificial intelligence (AI) was being used more than ever across Moffitt Cancer Center, said Edmondo Robinson, MD, MBA, MS, FACP, senior vice president and chief digital officer at Moffitt Cancer Center.

What new technologies or services did Moffitt implement during the pandemic that you think have good applications after the pandemic is under control?

A couple of things that come to mind in terms of response to the pandemic in order to make sure that we were still driving our mission to prevent and cure cancer. So one — and this is common, you hear this theme for everyone who responds to the pandemic — which is telehealth, telehealth, telehealth. Right? And so, you know, we pivoted very quickly. We had a 7,500% increase in our telehealth visits. That's come down since the height of the pandemic, but not all the way. So, there's some middle ground in there between where we were before, and where we were at the height of the pandemic. You know, virtual visits are just gonna be a standard channel through which to deliver care. 

And so you know, that there's a whole suite of activity that has to go with that. All the workflows, you know, the technical components, as well as just making sure patients are ready for that. There's a concept of digital health, in terms of literacy, right? So we think about literacy, and then there's health literacy, and then there's digital health literacy, right? And so, we have to actually pay attention to that. 

But in parallel to really, one, getting getting a lot of our employees to work from home, and then doing the virtual visits, something else that happened in parallel and actually continued to accelerate during the pandemic is the leveraging of artificial intelligence throughout the enterprise, though. So, everywhere from predictions of outcomes, like sepsis, to driving our business operations, leveraging robotic process automation, for example, but layering in artificial intelligence so that with AI, the bots are  not just automating, the AI is finding the next opportunity to automate or the AI is fixing the bot if it breaks on its own. Those kinds of concepts.

So again, leveraging AI everywhere from business operations to clinical operations, is another thing that we actually accelerated during the pandemic.

Dr. Edmondo Robinson Highlights the Growing Use of AI

Bryan Dickerson serves as the senior director of healthcare workforce solutions at Hospital IQ. Bryan has 30 years of experience working in healthcare, specifically with product management, customer experience, and software solutions. At Hospital IQ, Bryan applies his expertise to create the tech solutions that solve the challenges hospital leaders and administrators face with scheduling and staffing.

Staffing shortages and burnout were familiar to hospitals and health systems pre-pandemic but were dramatically exacerbated by COVID-19. The pandemic solidified the need for hospitals to be able to allocate staff and resources when and where they are needed most. The ongoing COVID-19 surges reinforced the value of investing in long-term, sustainable staffing solutions that provide the visibility hospitals and health systems need to optimize their valuable staffing resources.

Many hospitals and health systems are still relying on manual, disparate staffing strategies and technology which results in inefficient, crisis-minded staffing choices. With 62% of hospitals reporting a nurse vacancy rate higher than 7.5%, according to a 

, health systems cannot afford to ignore the need for staffing and retention improvement. The adoption of a more effective staffing model must be top-of-mind for hospital leaders heading into 2022 and beyond.

The key to strategic, effective, painless staffing revolves around achieving enterprise-level transparency and adopting a centralized approach. Centralized staffing, by definition, is a holistic, enterprise-wide approach that fully leverages all staffing resources across the entire organization. Unit leaders and the central staffing office (CSO) need the ability to view staffing at the regional, facility, and service line levels — and various combinations of all three. With these tailored views of current and future staffing needs and gaps, they can determine how staff resources can be fully leveraged. For example, the staffing team can look at critical care staffing needs across hospitals within a certain geographic proximity to determine proactively how intensive care unit staff can be shared effectively by facilities within that region.

While many hospitals still struggle with siloed or unit-based staffing processes, outdated methods of communication, and limited data-driven insights, more and more organizations are adopting the technologies and processes that deliver the required level of transparency. By strategically leveraging their own internal data, for example, and adopting a centralized staffing model, hospitals can gain cross-unit visibility into staffing details and utilize predictive analytics to staff smarter. This not only improves hospital operations and efficiency, but also ensures high quality care for patients, and helps reduce factors contributing to staff burnout.

The Value of Increased Insight for Staffing Leaders

Full transparency across the enterprise is critical when trying to staff effectively. In order to successfully plan for future staffing needs — which eventually become current needs — staffing offices are turning to the utilization of predictive data analytics.

With the application of predictive analytics, CSOs gain accurate, specific insights into future staffing needs across the enterprise, in addition to what it will require to meet those needs with available staff. They are also receiving actionable recommendations about how to best address projected gaps before any resulting problems arise. This foresight reduces the need for desperate, reactive last-minute staffing measures and drives smarter operations. Unit leaders can now achieve more intelligent resource allocation, deliver higher quality of care, and gain valuable time back to spend with their patients; all because of efficient scheduling and improved open shift management from the CSO.

Enterprise-wide, enhanced insight into operations and staffing is a key part of creating a comprehensive, centralized staffing model, but only one part. With those insights in hand, leaders can then take a few key steps to truly advance their organization’s staffing practices.

Keys to Successfully Adopting and Executing Centralized Staffing

Centralized staffing depends on clear, actionable, well-defined processes. Staffing processes, and every person’s role in those processes, must be clear-cut and understood by all to make this approach successful and achieve the many outcomes it can enable. Adopting and deploying a centralized staffing model may look or sound overwhelming at first, but if broken down into phases and key actions to take, hospitals and health system staffing leaders can see immediate improvements without added pain points that sometimes come with other process changes.

Teamwork and creating a more collaborative environment areessential. 

CSOs must collaborate with each unit and all nurses to create and manage the most efficient schedule and staffing plan. The entire team must work together to resolve staffing issues and fill forecasted gaps as needed. Trust is a huge success factor, and increased transparency can aid in that. When unit leaders gain trust in their CSO, they are more understanding when asked to share staff because they can now more easily see where the needs really are and know they will receive the same support when their unit needs it.

Strategy must become the driving factor behind all staffing decisions — fully replacing reactivity and crisis-driven actions.

 When staffing and scheduling, CSOs need to be thinking and acting strategically, which must be supported by data-driven intelligence. With expanded organization-wide staffing data made more accessible, CSO teams can now become better problem solvers. Increased data allows them to balance staff across the enterprise, deploy staffing resources quickly, and provide informed guidance to mitigate staffing shortages. So many staffing issues are alleviated when staffing moves from a tactical to a strategic process.

Staffing as an enterprise, not just a unit, is hugely important for successful centralized models. 

To optimize an organization’s staffing resources and effectively staff across all units, everyone — from unit managers, nursing leaders, and those in the staffing offices — must understand and help meet the needs of each individual unit. With a centralized staffing model and advanced data analytics technology, staffing leaders can minimize floating, an often-frustrating process for nurses, by applying knowledge-based staffing while avoiding understaffing as much as possible. Staffing with a centralized, enterprise-wide approach not only creates a better experience for nurses and other care teams, but also ensures consistent, high-quality care is delivered across the board.

Hospitals and health systems cannot afford to lose any more of their crucially important staff due to lack of planning, lack of insight, or lack of proactivity. By embracing advanced technology and changing the methodology in which they staff from siloed to shared, staffing offices can adequately staff and manage schedules while increasing satisfaction among unit leaders and nurses, all of which drives better work environments, as well as improved care and outcomes for patients.

Hospitals and health systems cannot afford to lose any more of their crucially important staff due to lack of planning, lack of insight, or lack of proactivity.

Adopting Centralized, Enterprise-wide Models for More Effective Staffing

Although a slightly higher percentage of patients with cancer prefer telemedicine to in-person visits, satisfaction scores were equally high for both, according to a study from Memorial Sloan Kettering (MSK) Cancer Center researchers. The findings were 

JNCCN—Journal of the National Comprehensive Cancer Network

The researchers assessed satisfaction and preference from 1,077 survey responses from radiation oncology patients. The patients received care at MSK’s main campus and six regional locations in New York and New Jersey. They were evaluating office and telemedicine visits that took place between December 2019 and June 2020.

A total of 726 of the patients were seen in office for prepandemic visit and 351 patients had telemedicine visits during the pandemic. The median age of patients with telemedicine visits was 65 years (66 years for office visits).

Satisfaction was largely the same. For level of concern by the physician, 92% of patients with a telemedicine visit compared with 93% of patients in office selected the top score. Similarly, 94% chose the top score for telemedicine and 94% for in office when evaluating the friendliness of their physician.

When rating the quality of their physician’s explanations, there was a slight advantage to telemedicine with 91% of those patients selecting the top score compared with 84% of patients who had an in-office visit.

“These findings provide some evidence that there is a role for telemedicine beyond the COVID-19 pandemic and that it can be a particularly useful tool for certain patients—especially those who may have challenges coming on-site for an appointment,” co-lead author Narek Shaverdian, MD, MSK Department of Radiation Oncology, 

. “Giving patients flexibility and options by being able to see them both in-person and through telemedicine can improve access to care.”

According to the survey results, 45% of patients preferred telemedicine, 34% preferred in-office visits, and 21% had no preference for their visit type. Patients who were married or had a partner and who had better performance status were more likely to prefer in-person office visits.

Patients who had a telemedicine visit that included video conferencing were more satisfied. In comparison, patients who had a telephone-only appointment were more likely to say they would benefit from an in-person visit. Shaverdian noted that voice-only encounters with new patients are particularly challenging and telemedicine is really a benefit for patients who have and can use video capabilities.

“Digital tools like telemedicine have the unfortunate potential consequence of paradoxically increasing disparities in access to care,” said co-lead author Erin F. Gillespie, MD, MSK Department of Radiation Oncology. “But the counter to that is there will be some disadvantaged patients that would not have accessed the system at all, either due to technologic barriers or travel time, and now can connect at least by phone, which is an important and positive change.”

While one-third (34%) of patients who completed the telemedicine survey agreed with the statement that “cancer care will be negatively impacted” by the COVID-19 pandemic, only 8% were concerned their own cancer would not be treated successfully because of the pandemic.

Delays in diagnosis and treatment of cancer

 have been well documented and are expected to cause tens to hundreds of thousands of excess cancer deaths. 

, screening and treatments for breast, colon, prostate, and lung cancers saw a particularly harsh decline, according to a study from Avalere Health and the Community Oncology Alliance.

“Telemedicine maintained patient confidence in the physician and treatment, but efforts to increase access to audiovisual technologies must be prioritized to improve patient– physician communication,” the authors concluded. “These data should help inform efforts to maintain access to telemedicine for patients with cancer beyond the pandemic, while highlighting the importance of equitable access to audiovisual technologies to support the most vulnerable patients.”

Patients receiving care at Memorial Sloan Kettering preferred telemedicine visits over in-office visits with similar satisfaction scores.

Patients With Cancer Prefer Telemedicine to In-Person Visits; Satisfaction Is the Same

Doug Mitchell, MD, MBA, is co-founder and CEO of Adfinitas Health, a physician-owned and managed healthcare management practice serving clients in both easy- and difficult-to-recruit geographies.

The healthcare industry and its employees are facing challenges today filled with uncertainty. There is no clear idea of what the "new normal" will look like after the effects of the COVID-19 have subsided. However, what is clear is that challenges were already concerning for hospitals in a pre-COVID-19 environment. 

 published by the American Hospital Association, the median margin for hospitals in the United States before the pandemic was just 3.5%.

Now, the pandemic generated a new set of problems on top of those many hospitals already struggled with, like growing self-pay collections, increased administrative burdens and regulations and plummeting reimbursements. With the cumulative effect of these issues, the industry may go into the red. As the report predicts, this means that nearly half of all hospitals could have negative operating margins by the end of 2021, with rural hospitals feeling the impact more harshly.

To make matters worse, there is also the added stress level of the clinicians feeling the effects of burnout. Even before the pandemic, the rate of burnout was already high, with 40% of physicians 

 of clinicians are ready to leave the industry entirely leading to a shortage of approximately 124,000 clinicians by 2034, as 

 published by the Association of American Medical Colleges. This shortage will adversely affect the entire system, especially physicians who remain and patients who will still need treatment.

What is important to understand is that there is a way through these challenges without arriving at this possible future. Solving operational challenges starts by looking at operating models and staffing from a new perspective. Partnering with a multi-specialty healthcare management company can help hospitals maintain the highest quality care while gaining improved operational efficiencies — both of which are critical in the journey toward post-pandemic recovery. To this effect, there are three areas of focus that a hospital should emphasize and in which the partner should excel when looking to choose that partner.

When looking for an experienced hospitalist partner, they must understand the hospital they are working with. They should demonstrate understanding of its culture and where they fit into it. Not only does this mean exhibiting quality leadership, a willingness to roll up their sleeves, and work alongside hospital leadership, managers and clinicians, but it also means that they are a part of the team, and they are accountable for how that affects patient care. Partners should collect and analyze key performance data to identify opportunities to improve clinical and operational performance and focus on the care they are helping to give as if it were their community.

It is clear from the struggles persisting in the healthcare industry thus far that returning to the operational strategies will not be the way forward. The status quo cannot continue, and it should not be the plan of their new partner. Looking at a new way forward, hospitals need to choose partners committed to innovation and ongoing learning. Look for organizations that think outside the box, such as using a model that trains and employs high-performing advanced practice providers.

Care does not end when the patient leaves the hospital, but in reality, it is difficult to continue this care after they leave. Lack of follow-up care leads to readmissions, emergency care, and potentially life-threatening complications. 

 that nearly one in five patients experience an adverse event within just three weeks of being discharged, 75% of which could have been prevented or alleviated. The three primary reasons are hospital-acquired infections, procedural complications, and adverse drug events.

A hospital should be looking for a partner who understands this and looks for ways to relieve this issue through telehealth outsourcers for post-acute care and remote patient monitoring. A potential partner who demonstrates an understanding of the importance of providing consistency and quality in every patient encounter, no matter where the patient is in the healthcare spectrum, is the right partner.

With all the uncertainty we face daily, it is good to know that the right partner can get the industry to whatever that new normal may be. The ideal partner will provide experienced hospitalist medical directors that oversee financial and clinical care components of your program while you maintain complete control of overall operations, while also delivering consistent, high-quality care through continual communications with your hospital staff, your patients and their families.

Doug Mitchel is co-founder and chief executive officer at Adfinitas Health.

Solving operational challenges starts by looking at operating models and staffing from a new perspective.