People-first healthcare, even in the aftertimes
We should be proud that Oregon's healthcare systems were the first in the country to create a collaborative IT system to combat the Covid-19 virus. But we should demand more.
Brian is a native Oregonian and urologist at the Oregon Health & Science University. He is heavily involved in health policy and currently serves as president of the Oregon Urological Society.
As of March 7th, 2021, the Johns Hopkins Coronavirus Resource Center reports that 524,668 Americans have lost their lives to Covid-19. Without question, this is one of the greatest tragedies to befall our country and the world within our lifetimes. To make sense of this suffering, we must capitalize upon the unique opportunities only a calamity of this magnitude can afford. However, to have any hope of meaningful success we must be willing to shed the shackles of bitter partisanship and self-interest.
Unprecedented collaboration between Oregon’s major healthcare systems in response to Covid-19 demonstrates that community-minded, pragmatic action is possible. Collaboration of this sort seemed out of the question pre-pandemic; post-pandemic we need to make sure coordinated care among competing health systems continues.
Collaboration is far from the norm in our health care system. Despite comprising nearly one-fifth of the economy, the US healthcare system is not really a system at all. Rather, it is composed of various independent private and governmental entities whose competing interests result in the most expensive healthcare in the world while producing only average clinical outcomes.
I’ve seen numerous examples of this during my career. Patients with life-threating conditions being transferred hundreds of extra miles to ensure their higher level of care is not delivered by a competing healthcare system closer to home. Patients who cannot afford healthcare presenting a year or two later with far more advanced and costly disease. This need not occur, and the pandemic has shown it is possible for competing health systems to work together in a people-first, rather than profit-first fashion.
On February 28th, 2020, the first confirmed case of Covid-19 in the Portland-metro area was reported by the Oregon Health Authority (OHA). In response, Oregon Health & Science University (OHSU) partnered with OHA to develop a state-wide hospital-capacity contingency plan. This required real-time information throughout the state regarding the availability of acute and critical care hospital beds and valuable resources such as ventilators and extracorporeal life support machines.
Thankfully, OHSU had recently partnered with GE Healthcare to develop an information technology (IT) system known as Mission Control to help guide the flow of patients across its four hospitals. OHSU didn’t keep this essential system to itself; instead, they selflessly integrated it into a statewide response. Mission Control served as the blueprint for creation of the Oregon Capacity System, which tracks in real-time the availability of nearly 7,400 hospital beds and 800 ventilators across Oregon. Data from this system have been used during the pandemic to help inform public health mandates and regulate the flow of patients throughout the state to ensure no health system becomes overwhelmed with Covid-19 patients.
According to Jeff Terry, MBA, FACHE, global CEO of GE Clinical Command Centers, "The idea that health systems will be so transparent with their peers is revolutionary. On a day-to-day basis, big health systems are sort of 'frenemies;' they all collaborate a bit, but they also all compete a bit. The fact that everyone came together in Oregon and did this was a big deal.”
Indeed, we should be proud that Oregon's healthcare systems were the first in the country to create a collaborative IT system to combat the Covid-19 virus. But we should demand more. The same tools could be used to coordinate care for Oregonians afflicted with other life-threatening conditions. Why should a patient suffering a stroke be transported hundreds of miles to an affiliated hospital, when a neuro-interventional radiology unit is available across town?
Tragically, well-intentioned providers frequently have no way of quickly knowing what resources are immediately available outside of their health system. The full potential of people-first healthcare will only be realized if Oregon’s health systems remain committed to collaboration post-pandemic and choose to expand the types of medical resource-data they are willing to share with their “frenemies.”
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