COVID-19 began taking hold of the headlines and the economy about a year ago in Dallas. While it will forever impact almost all industries, the healthcare sector was the front line of fighting the disease and had to be more agile, innovative, and resilient than ever.
D CEO Healthcare is sitting down with health system CEOs to reflect on how the last year changed them, their health systems, and the industry forever. Read on for insights, takeaways, and silver linings surrounding fighting the pandemic from Barclay Berdan, CEO of Texas Health Resources.
Barclay Berdan (Courtesy: Texas Health Resources)
What did you learn about Texas Health Resources during the pandemic?
“If we put our minds to it, we could pivot the organization and reinvest our capabilities and very particular things in just a matter of days to a week, in order to change the organization to respond to what we were learning and what we were experiencing.”
How did Texas Health Resources prepare for the pandemic?
“We have a partnership with ambulatory surgery centers, and we have about 18 or so of those ventures across Texas. As we were trying to anticipate what we might experience in a real big surge of patients like we were seeing in other parts of the country and the world, we had to see what we could do with our partners to bring their resources to bear in the hospital. At that point in time, we were looking at actually moving ventilators from the surgery centers, converting anesthesia machines into ventilators. We went through some orientation and training in terms of how to use some of our systems and electronic health records. The first time we shut down operations, they closed their surgery centers for that period of time so that those folks would be available.”
What was a challenge you experienced along the way?
“We moved to the point where testing became the big issue, and we had to focus on how we could do a better job of finding approved testing facilities or doing it ourselves. We were successful in both growing our capacity as technology became available, as well as finding partners that could turn over the results for us. Back then, in North Texas, we were waiting five or six days to get a result back, which wasn’t helping anybody. We were keeping a lot of patients in hospitals, taking up beds at the time because we needed that definitive PCR test to come back. We went through similar cycles on therapeutics and then most recently a similar process with vaccines.”
How did the system’s experience with Ebola impact the way it dealt with COVID-19?
“Back when we experienced the Ebola patients, we observed the environment moving from science, to social science, to science fiction. We knew that was going to happen because we’ve seen it happen before. That helped us anticipate how we could deal with some of the lack of information or misinformation picked up in the media and on social media. We’re seeing the same kinds of things now, so we had to put in place a way to vet information and decide whether that was going to impact how we were caring for patients. What advice were we giving to physicians and employees as well as the public? We had a way to ingest that information daily and then, on a very rapid turnaround basis, get information out about what was truth and what wasn’t. At that point in time, the leadership team and our board spent a little bit of time thinking about what happens to the institutions that are essential for communities like hospitals when we have some form of a big black swan event. That caused us to be sure that we were strong financially, and that meant that as we went into the pandemic, we did not have concerns about liquidity.”
What change occurred during the pandemic that you think will stick around beyond the pandemic?
“The acceleration of virtual care and digital technology. When the pandemic started, we were in the process of implementing virtual care, and we had planned a pilot to start in January of 2020 with a small group of physician offices, but we had not planned to accelerate and grow through that for the rest of the year. But literally, in a matter of weeks, we were able to stand it up for all of our physicians, and I think we delivered over 170,000 virtual visits in 2020. We have made a number of improvements to the process as we’ve gone through that to make sure that it works better for patients as well as physicians. Virtual care is here to stay.”
Were there any silver linings to the changes you experienced during the pandemic?
“We focused our resources to create dashboards that were combined with predictive aspects of artificial intelligence. We got real-time information like we never had before. We could predict where supplies were being used faster than normal, down to a nursing unit. We didn’t wait until people ran short on supplies on their carts or in their closets. We could get there and restock it before they had that shortage. Anybody in the organization could see where the patients were, where the census was going up, and where we were going to run short on beds. That gave us the ability to adjust in real-time, or ahead of time, to whatever challenges we were going to face.”
What data and coordination issues did the system experience during the pandemic?
“Texas Health Resources’ service area covers about 16 counties, and every county had a little bit different approach to things. Quite frankly, the health systems around the state said, ‘Wait a minute,’ because everybody had a little bit different definition of what kind of data they wanted. We were having to dedicate several people to try and generate that information. And it was not just for reporting, but in terms of policies and procedures. When everything’s based at the county level, and you serve 16 counties, early on, there was not any coordination between the counties. In the very early stages of the pandemic, when we were in a true lockdown, a couple of us ended up with employees who were trying to drive to work and got pulled over by the police.”