EVENT ENCORE
Event Recap: Interdependence of Public, Private, and Federal Healthcare Delivery February 24, 2022 by Amanda Brummitt, FACHE Public, private, and federal healthcare delivery no longer have hard boundaries and patients often seek care across the different systems. Panelists were Aaron Bujnowski, FACHE of The Chartis Group, Jason Fisher of South Texas Veterans Health Care System and Eric D. Jacobsen of Veterans Affairs North Texas explained why these organizations should and do work together to create a healthier community. And, moderator by George T. Roberts, Jr., FACHE Northeast Texas Public Health District directed a great discussion and offered public health insight. To paraphrase a key point of the conversation, Bujnowski said, “We are all working towards the good of the community, so it makes sense to work with competitors to accomplish what the community needs.” At times, we don’t have adequate supplies, beds, or timely clinic appointments. It makes sense to be able to share resources and refer patients, so they get the care that they need. That’s why we are all here – to care for patients. Interoperability During Disasters The Veterans Administration (VA) is the largest integrated delivery system in the United States. In the COVID-19 environment, they used their purchasing power to acquire supplies and redistribute to community agencies that were desperate for supplies. Our North Texas VA helped many DFW area hospitals with supplies including Parkland. They also sent staff to hot spots around the country and utilized staff from around the country. Information Technology The pandemic sped up utilization of telemedicine, especially for psychiatric care. Most patients seem to prefer it. Organizations rapidly improved IT infrastructure to meet the need and drive site of care changes. No show rates dropped across the board with telecare, except for Veterans that are currently un-homed. Their no-show rate
26
went up during the pandemic. It will be vital to figure out how to meet the needs of this population. Documentation Sharing of information is vital across the systems for the best continuity of care, including social and emotional needs of the patients. The federal organizations currently have some interoperability to see certain components within electronic health records but would like to see more. The Mission Act and Choice Act allow some transfer of patient information between the public and private sector. A lot is still currently scanned into the record. Across the panelists, they welcome more interoperability. Costs & Reimbursement Organizations are re-evaluating cost structures and where their teams are physically working to be more efficient and unlock talent. Large organizations can share resources across the entity, but smaller organizations are being taxed with high costs of agency staff because of staffing shortages. Repurposing underutilized services and running as efficiently as possible helps. Private equity has played a role in providing funding to capitalize projects around technology for projects like home care and remote care. Better operability of electronic health records will help with reimbursement when working between systems. Future Homogenization of Patient Populations Patients with certain health disparities need care across multiple providers throughout the system to meet needs outside of just the medical needs such as social and psychological, but that are potentially root causes of the chronic illness. These issues can’t be met by a single health system.
A Publication of the American College of Healthcare Executives of North Texas Chapter | SUMMER 2022
