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Today on Town Hall

So now when you go into a doctor's office, they've got the capability of seeing everything that's happened with you. And they can even customize what they want to see. So maybe they only want to see the last lab. Okay, I've got those. But what they want to see in the last five years of labs, they can see those trended graphed out

My name is Bill Russell. I'm a former CIO for a 16 hospital system and creator of This Week Health.

Where we are dedicated to transforming healthcare, one connection at a time. Our town hall show is designed to bring insights from practitioners and leaders. on the front lines of healthcare. .

Alright, let's jump right into today's episode.

  All right. Welcome to Town Hall. And today we have a special guest. We have Jim Matney, President and CEO of Colquitt Regional Medical Center. Jim, welcome to the show. Thanks, Bill.

I look forward

to

talking to you

about it.

So this is your first podcast ever that you've been

on? First podcast ever.

Wow. And it's it's quite the honor. Well, let's talk about tell us a little bit about Coquit Regional.

Well, we just recently came to a name change, which is Coquit Regional Health System, because we felt like Coquit Regional Medical Center was more just a hospital.

Cool. But we're kind of more than just a hospital. We have three residencies. We have a family medicine residency, we have a psych residency, and we have a general surgery residency, and we're getting ready to start a OB residency. All that in a 99 bed hospital, you can imagine. We live in rural Georgia, a place called Moultrie, Georgia.

When I first got here, our biggest struggle was trying to recruit physicians. And we just were not successful because if people have a chance to live in Atlanta or live in a place where there's more restaurants, they tend to choose that. So I decided to build my own. So we started what we call the Georgia South Residency, and it's just.

It started out like a rule track where we, and I think you interviewed Scott Steiner at Phoebe once. So we became part of their residency, and then as we continued to we kind of went independent on our own. So we just started our residency programs. And then from that we started home care, hospice, and then we just bought a nursing home.

So, and then we bought a rehabilitation center. So, and all that in the, kind of the boundaries of Coquitle County. So, We recently have increased our bed size back to 155 beds because we have 99 beds and like today our census is 108. So

you really are the hub of care for that region, I mean from birth to aging.

And 30 percent come from, this is from outside, from the region for general surgery care too. So, it's just amazing how we did, and we did it on the, with the Meditech platform. I mean, you know, as we continue to grow, like our cancer service businesses, we started out with another software system and then our cancer service got bigger and the biggest complaint was How do I get that medical records?

So, we hear a lot about the fact that rural healthcare organizations are struggling. You guys appear to be thriving even growing through this, what do you attribute that to? I mean, where does, where does that, come from? Is it the flexibility to go where the community is asking?

I mean, what do you ascribe that to?

Bill, and I know my colleagues won't like what I say, but how in the world can you not make a profit when you're full. When you're at capacity and it's like during the COVID, you heard all these hospitals poor mouth about how hospitals are doing terrible, but the hospitals were full.

And if it's a cost structure thing, so, and I'm an economic person by education too, that if you keep your cost steady, especially on a per unit basis, if that cost per unit stays consistent, then as you add more volume, you make more income. Now, we're not making tons of money, but we're able to reinvest back into our community.

So, since we're not a for profit and we're not part of the system, like last year, we put 26 million dollars of the 28 million that we made back into the hospital on new technology. like new CT scanners, we've added a PET scan, we've added a radiation oncology. So basically, we look at the needs of our region and we add technology to that.

We're one of the few hospitals that participate in the intuitive plan for where we're teaching hospital and we have four robots in our Six surgery suites. So I think that the key is the fact that we listen to see what our needs are in our community. We understand what we can and can't do.

And we provide the latest and greatest technology with a customer service focus and a quality focus. One of the things that we're proud of is that for 19 times in a row, we've actually got an A on the LeapFrog patient safety score. We focus on quality, we focus on customer service, and we focus on technology.

wow, so you've received that. I kind of

answered the question. The difference between our rural hospital and another rural hospital is that we don't let the wilderness define us. We make sure that when you're coming here for an MRI, You've got a 3T MRI. When you're coming here for a CT scan, we have two 128 slide CT scanners.

When you're coming here for surgery, because a lot of people choose robotic surgery, we've got four intuitive robots in our OR suite so that people are getting the same care that they would get either in Atlanta or in Albany or in Moultrie, Georgia. So

You've personally won a couple of awards, just want to call it.

This is one of the things that's a concern is, you go to Atlanta, you can receive better care than you can in rural Georgia. That's one of the concerns that we have as we have this. It looks like you started with the residency program and bringing in high quality residents.

And then you essentially you layer on that the investing back into the technology and the things that they need to be successful.

So, we approached the Philadelphia College of Osteopathic Medicine and convinced them to open up a medical school, a four year medical school, right here in Moultrie. And so that's been a great partnership. If you think about those awards I won, it was because we really transformed this whole community to where we've got a 47, 000 population, but we've got a four year medical school right here in Moultrie.

And that, those medical students fed into our residency. Which the residency is fed into positions on our staff. and by doing it from the start, so you get your third year residency, and you're talking about quality, you're talking about customer satisfaction, and you kind of get them and you grow them with the culture of the organization.

Quality, for example, we just won another award that we're getting next month where we won the GHA Patient Safety Award in the whole state for our work that we've done on sepsis, so one of the things that, that we talked about with sepsis is the fact that there is clear criteria of what you need to do when somebody is septic.

There's four different criterias in there. So we hardware that into our system to where literally when somebody comes in, you're checking the blood cultures. You're checking to make sure that the. Fluids are given at the right time and you're checking to make sure that you're going back and doing another blood culture and that you're delivering the right antibiotic to that patient.

Because when a patient is septic, they've got some type of infection going on. So, a lot of people will just throw different antibiotics at them. But if we can get that Blood culture done at the time when they're in that emergency room, then we can find out what that infection what antibiotic will react to it.

And if we can get that timely, within an hour, then we can deliver the right care. Versus and you talked about Atlanta. Okay, if you go, and the other thing is, we hardware at our emergency room. So, our average wait time is 22 minutes. Okay. From the time you walk in, do you see a provider? But before you even see a provider, at the triage desk, that nurse is already ordering the labs, she's ordering the x rays, so that when the patient does see the doctor, they've gotten all the results there.

And that's what we've been able to do is to get the flow. Going to where everything works perfectly. Versus if you go to Atlanta, you might sit in an emergency room for hours and hours. You hear about these long waits in these emergency rooms. Well, our average patient waits 22 minutes. Yeah, so they're

sitting.

I'd love to we spend a lot of time talking about the intersection of technology and healthcare. You mentioned Meditech and we were talking a little bit about this before we hit record on this show. I was with a Meditech shop, 16 Hospital Meditech shop in Southern California and you guys run Meditech.

one of the things I appreciated about it was It runs a health system very efficiently. Like it's a really good system. It's a really good platform to run a health system on and it's incredibly efficient. I'm curious, tell us a little bit about your partnership with Meditech.

Well, it's been a long partnership. I mean, like I worked years ago for a for profit company that had Meditech. So I knew that Meditech could be nimble. Meditech, you could move it and make it do what you want it to do. If you think about a lot of EMRs, Many EMRs, it's just, it's as good as what, how you create it.

So I knew that Meditech had the kind of the ability to do it. So with what we've done with Meditech is like for our physicians, all of our physicians are on Meditech. Well, we also put our home care on Meditech. And we put our hospice on Meditech, we put our rehab on Meditech, we put our cancer on Meditech.

So now when you go into a doctor's office, they've got the capability of seeing everything that's happened with you. And they can even customize what they want to see. So maybe they only want to see the last lab. Okay, I've got those. But what they want to see in the last five years of labs, they can see those trended graphed out.

So the thing that I get excited about Meditech is one, it's very efficient, but two, it's moldable. You can mold it the way you want it to happen. lot of EMRs, they give you this, and they say this is what it can do, and you'll say it can't do that, it can't do this. Well, with Meditech, we've been able to actually fix it the way we want it.

And customize it, not just at the system level, but the individual physician can customize then if Dr. Sproul, for example, only wants to see certain things, what he doesn't impact Dr. Jones over here, because Dr. Jones might be a rheumatologist, that they just want to see certain things.

So every single physician can customize it the way they want, but then I can pull all that together from a system standpoint, And look at my quality, look at my revenue, I've got real time revenue, I've got real time quality results that I create a dashboard every day. that gives me a dashboard of what do I need to see as a leader to make sure that our quality is good, our patient satisfaction and our financial results.

Yeah, I mean, you talk about the customization. I remember this is a weird story, but we had implemented Meditech and one of the doctors kept complaining and he just said, I hate this. It doesn't do what I want it to do. So we took one of our champions and we sent them down to work with them. And then he helped them to customize it.

I remember going back down to him like 30 days. He was supposed to learn all that through training, but he didn't need the training, of course. But, 30 days later, I went down to him. He's just like, this, it's amazing. It's like life changing. Customizing this is, It's like changed my life.

And it's like, yeah, it's, I think sometimes people just limp along when, if they would just take that time and customize it, it becomes a tool that fits their workflow and their way of practicing.

That's a game changer for us because when we went up to put the positions on MediTag, just like any EMR change, you get a lot of complaints.

Whenever you implemented a new EMR. Everybody hated you. Well we brought in one of those champions from Meditech too, which really worked to work with the docs to customize the EMR, the way they want it. And I always check back with them and they tell us. Great. And the interesting, one data point, and I'm a big data point, is that we use PRESS GAINING to do physician satisfaction scoring, one of the interesting things is, and one of the questions is, do you like the EMR system that this health system is using, and we scored on the 73rd percentile nationwide, which is higher than the national average significantly because you can imagine the national average is 50.

So that's the 50th percentile, that's average. We scored on the 73rd percentile of physician satisfaction with our EMR system. And it's primarily because of the fact that we have been able to customize.

Yeah, I remember talking to that doctor. I said to him, I'm like, do you have an iPhone? He said, yeah. I said, did you download some apps?

He goes, oh, absolutely. I'm like, did you move them around? Did you put pictures on? He goes yeah, yeah, yeah. I'm like, So if I took that and restored it to its default, would you still like that phone? He goes, no. I'm like, well, that's what you've been using since we installed it. It's the default. Now you have your version that helps you.

want to talk a little bit about health equity. Talk a little bit about the health equity in rural communities, like, like, Colquitt that you guys serve.

Well, and that's the big requirement for CMS and Joint Commission is that people start the initiative to where they're asking people, do they have, I guess the best example is a person with COPD and you wonder why they might keep flipping back and being readmitted.

Well, with Health Equities and with their system, we were able to build in five basic questions like, Do you feel safe at home? Do you have money for food? are you able to pay your rent? Are you able to keep utilities going? Well, we were able to build those into our questions that the nurses asked them and then pinpoint what were some of the issues with health equity having.

And we found out food showed up in every single category as a problem that people tend to not buy their medications because they're purchasing food. Well, as a result of that data that we were able to get out of the questions, we started this food program with our foundation where patients that are discharged, we send them home with food that weekend with meals that we get donated, or we probably don't, so that we can take care of the food.

And then what we found was those patients that we were sent, we started out on just one floor and then we moved it to all the floors of the people that showed up as food as a problem. And that's where we were able to take some of the health equity questions and put it to action application.

Another example is in our pediatric unit. We found that patients that come into our emergency room, lots of times the doctor would say, okay, you can go home and do Pedialyte. over the next three days, and your child is going to be fine. Well, Pedialyte cost, I think, somewhere around 7.

25 each. Well, what we found is that those mothers don't have 21 for three servings of that. So, looking at the health equity data, we figured out that there was some problems with food and drugs, so we were able to put those , patients in the hospital, which increased our emissions. But we actually were able to give them better in one day by giving them fluids overnight.

And that all came about because of the health equity data that showed pediatric families have a difficulty in either paying rent or with food.

It seems like a logical approach to this. I hear you correctly that you have an economics degree? Is that what you have? I got a

minor in economics. I got my degree in business administration with an emphasis in accounting.

Wow.

, because it's, interesting. My degree is in economics as well. I ended up in technology, but it's in economics. The great thing about economics, I think, is it teaches you how to solve complex problems.

It really does.

And it, it seems like you've solved a lot of really complex problems.

I'm going to give you the last word on the episode. What haven't we covered? What's the question I haven't covered that you're kind of surprised that. We haven't talked about.

I think the big question is the fact that the CEOs need to not delegate so much out that they're away from what the information's telling them.

Probably the key to our success a dashboard. And I would tell every CEO, create at least one dashboard of key areas that you really need to look at on a daily basis, a weekly basis, and a monthly basis. And have your quality data in one section.

Have your patient satisfaction in one section, and then have your key revenue and collection statistics in the other ones, and then have your volume over there in your other departments, because it's almost like spinning plates. You remember the old thing that the guy would get on and send the plates, and if you go over and try to spend another plate, this other plate starts to go off track.

Well, to me the key to success. as a leader is making sure all the plates are spinning. And the only way you can do that is build yourself just a dashboard. And the dashboard I've got, I've used for 40 years. It's got modified with quality and other stuff on it. And then you take five minutes a day out of your time to look and see where the areas are that you need to focus on.

You might see that MRIs are being slowed down. Well, why is the MRI slowing down? So you might need to call them. You might see that your Medicare length of stay is starting to creep up a little bit, so you might need to focus with case management. And having a dashboard that tells you cost, tells you revenue, tells you quality, and tells you patient satisfaction, to me, is the key.

I think the criticism I would have of some of my colleagues is they delegated this out to other vice presidents and they're just not looking at it. Yeah,

I think the other thing I would mention is I've seen some of these dashboards and they're like 15 pages long. It's like one

page.

Yeah, it's got to be something that you could scan See red, yellow, green, and go that's not right.

Well, I love your red, yellow, green, because my dashboard has the stoplight on it. And it's got red, yellow, green, and it's one page, and, if something else needs to be added to that, I pull something off. For example, if we look at inductions prior to 39 and a half weeks. We had that problem years ago.

So I started tracking inductions within, for prior to 39 and a half weeks, and then we hit where we hit zero inductions, and that was a quality indicator that everybody was looking at. We hit that for five years, so I took that off, and then I just look at it occasionally. CDIF, for example, if you, we just finished COVID.

The pandemic. So you had all these patients coming in and we were throwing tons of antibiotics with them. So our C. diff, which is basically a symptom of taking too much antibiotics, started getting up. We had 17 cases in one year. We went from 2 to 17. Well, that wasn't on my radar until I looked at the end of the year.

But you really do need to modify what you're looking at almost on a monthly or every two month basis to keep the organization going.

And we'll close with this. Who's going to win the national championship this year? George, George, that was, that was, that was too easy, I guess. But you know, I could have given you who's going to win the SEC championship game, because we're, I'm interviewing you before it, but it will probably air after it.

So this could make you either sound really, Real, really

smart. That has to do with Georgia Docs. Now, how's

Penn

State doing?

Well, Penn State has to play the number one Oregon team this weekend for the Big 10 Championship. And I, to be honest with you, I think that Penn State will win. the Big Ten championship, but I do believe that Oregon will win the national championship.

If they win the national championship, they'd have to play Georgia, wouldn't

they? Well, not with eight teams. I think it's, isn't it eight teams this year for the championship?

I think,

I'm not

sure.

Yeah, I'm curious to watch this new This new playoff and see how it plays out. But will be an exciting couple of weeks of college football, for sure.

Jim, I want to thank you for your time. I want to thank you for the great work that you're doing in rural healthcare in, in Georgia.

The one thing I would tell everybody is that frequently get on calls for Meditech or something like that. If you really are considering an EMR system, and whether it's Meditech or not, talk to somebody and get the pros and cons and get the thing.

And I'm always available to take a call from somebody that says, Hey. I'm looking at Meditech. Can you tell me the pros and cons of it? Because, yes, do I think some of these systems have a lot more bells and whistles? They do, but it's kind of back to your 15 page dashboard. How much of that can you really use?

And that's the good thing to me about Meditac. And I was talking to somebody the other day about it. I said, the implementation's easier, the cost structure, the annual costs and the back costs are just insignificant.

Yeah, I agree. Only

available for a phone call.

Sounds good. Thank you again for your time.

Really appreciate it.

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