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November 13, 2024: As healthcare costs climb, staffing shortages intensify, and patient needs evolve, many hospitals are making the tough choice to close departments or reduce services. Join Kate Gamble and Sarah Richardson as they delve into the consequences of this trend—from the CXO perspective on resource reallocation to the role of telehealth in bridging care gaps. They explore the strain on rural healthcare, the impact on maternity services, and how collaboration and data-driven decisions could offer hope.

01:06 CXO Perspective on Service Closures

03:07 Alternative Care Options and Telehealth

05:08 Community Collaboration and Future Outlook

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Transcript

Today in Health IT, we're discussing 25 Hospitals Closing Departments or Ending Services.

I'm Kate Gamble, Managing Editor at This Week Health, where we host a set of channels and events dedicated to transforming health care for One connection at a time. I've spent the last 12 years interviewing healthcare leaders and I'm excited to bring that knowledge into this community. So today we're discussing the wave of hospitals that are closing departments or discontinuing services.

And I am joined by Sarah Richardson, President of This Week Health 229 Executive Development Community. Sarah, thank you for being here. Thanks for having me, Kate. So we're talking about a recent article which reported that 25 hospitals are closing departments or reducing services due to financial strain, staffing shortages, and shifts in patient demand.

So this trend impacts healthcare access and emphasizes the need for efficient resource allocation. And some of the service closures we're seeing include maternity and OB services And of course, there's a big impact on the rural community. So let's break this down a bit.

And why don't you talk a bit about what this really means from the CXO perspective? When I saw this article, it was an eye opener for me to realize that maternity and outpatient were some of the most highly affected services. And I was. Back into my days of being a CIO and I'm like, okay, how can I help my organization be successful if these business lines have closed?

And I really thought about resource optimization, that our IT investments should focus on supporting essential services. And really leaning more into telehealth, that whole access to care. If you can expand virtual care options, you can also help to mitigate service gaps. And then, as always, making sure that our decisions are data driven.

The insights that we're going to get from data can guide which services are necessary to retain. based on community needs. And the other piece that's really important in all of this is that we talk about healthcare being local. And as a CIO, when you know the other CIOs in your market, then That conversation potentially made outside of your sphere of influence.

Hey, we're closing these areas for these reasons you likely do know. And then you're reaching out to the brethren in the community to be able to say, we just closed this, but you have this let's make sure that. You have everything you need to be successful here, but more importantly, you're starting to pull those technical conversations about interoperability and data exchange across the systems, because you may have just closed a labor and delivery unit, the one a mile away is remaining open, it might be your competition, yet in this case, they're actually.

It's that co opetition that we talk about. They're your partner in ensuring that there's great maternal and child care because those patients may come to you for something else. So you've got to have access to all of those records and that information effectively. Yeah, just yet another pitch for collaboration, why that's so important and knowing the other CXOs in your community.

And so there are alternative options that people are going to do. You did mention seeking care at nearby hospitals or clinics, but there's a few different things here and wanted to get your thoughts on that and how that affects leaders. One of the things I still really focus on is the telehealth perspective.

It's available in all 50 states, though the level of access and specific regulations could vary. You saw many states expand telehealth access during COVID 19, but some have since adjusted policies and the coverage for telehealth, including which types of care are covered and reimbursement rates may differ based on state regulations, insurer policies, and healthcare provider requirements.

So it's really important to make sure that you understand what you're offering to your patients and the availability that they may have for that. And the both the Seeking care at a nearby hospital, while that could be key, the community health centers also can provide low cost or some sliding scale options for essential services.

Home health is always an option, although something also has to be dug into from outpatient and post acute care perspective. And then when I think about access in rural areas, sometimes transportation is the hurdle, and having an assistance program So you can coordinate transportation assistance to facilities further away.

Also become options for patients versus just feeling like something has been taken away from them when you close a specific service. Yeah, that's such a good point to bring up. And there were a few CIOs who were talking about that a few years ago.

and,

now it's starting to become more common, and it has to be.

Transportation is such a basic need, but we've seen some unique partnerships with Uber and Lyft, and hopefully we'll start to see more of that.

And you mentioned home health.

Mass General Brigham has been a pioneer in this and they're doing really well. So there are these spots where some organizations really seem to have.

figured it out, at least as much as you can. And so it's so important to, be able to reach out to them and learn from them. Now, so we talked about the maternity services, OB, things like that being closed, and there's a lot of implications that come with that beyond financial, which is a huge part of it, but wanted to get some of your thoughts on that and really the effects that can have on the whole system.

Of course, and when you mentioned before about Organizations that are doing something well. When you're a part of our community, This Week Health and 229, you get to find out where things are happening that are working. You also hear what people's pain points are, and then you find ways to solution that together.

So if this was something you were facing Hey, we're going to close some of our women's services lines, understanding the financial constraint, often it's high operational costs with lower reimbursement, so if you have to close it to balance the budget. Then what does that mean for us in the ability to shift it to a specialized center, as an example, larger regional facilities that help increase that efficiency that may be where you are going to a Mass General, like you mentioned, and then staffing shortages are still one of the primary issues in terms of having specialized healthcare professionals like OBGYNs and midwives.

It can be challenging. to keep and maintain a quality women's service line open. And then rural is always going to have the higher pressure due to lower patient volumes, limited funding, and some of the geographical challenges that we have discussed. And so when you're connected to your community, when you understand the payer mix and the insurance implications, when you understand ways that you can still solve for a need that you are no longer able to provide, it takes some of that together.

Anxiety and burden of closing something the community needs and still being able to offer it in a way that two things, A is thoughtful in the approach that you have in your patient communications, but more importantly, we all are patients. And so if we put that hat on as well, how would we need to receive the information or be most informed to ensure that we still feel like we have options that allow us to be the healthiest and best version of ourselves.

very well said. And as we see more mergers and acquisitions, this is going to continue to be an issue, something that's really important and we have to keep our eye on. And telemedicine is an important option, but there are limitations, as you said, and we encourage everyone to advocate to talk with one another and share those best practices.

Thanks as always for your contributions to this, and don't forget to share this podcast with a friend or colleague, use it as a foundation for daily or weekly discussions on the topics that are relevant to you and the industry.

📍 They can subscribe wherever you listen to podcasts. Thanks for listening. And that's all for now.

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