Hospitals are changing with the times, particularly with the introduction of new technologies, as well as a changing funding paradigm. Special Sections Editor Brad Graves, with the help of Health Care Reporter Jared Whitlock, asked several senior hospital executives about the advent of new technologies and approaches — in short, what we might expect from the hospital of the future. Here are their edited responses.
President and CEO Sharp HealthCare
Q: Artificial intelligence is all the buzz in health care. How is your hospital using AI or how does it plan to do so?
A: While artificial intelligence (AI) is a frequent component in Sharp’s clinical and non-clinical systems, the field is in its infancy in terms of true utilization. The growing use of “big data” and AI holds much promise for improving care, driving efficiency and lowering costs. At Sharp, our electronic health record uses an AI-integrated algorithm to identify and predict sepsis in patients. AI is also used by HR and supply chain for predicting staff turnover and timely pre-stock of surgical supplies, for example.
Q: Health care is moving toward an emphasis on outcomes and value rather than volume. How is your hospital system preparing for this shift?
A: Sharp has long focused on three priorities in health care: delivering quality care and outcomes, improving cost efficiency and driving an extraordinary patient experience. In 1985, we committed to capitated reimbursement, a payment model that has helped drive these three elements, providing the best value and a healthier population. Success on this front requires dedication to continuous improvement, and our efforts were recognized nationally when we received the Malcolm Baldrige National Quality Award in 2007. This focus has continued to define the work we do each day for our patients.
Q: From a business perspective, what’s the greatest challenge and opportunity in San Diego health care right now?
A: Perhaps the greatest challenge is that health care revenues are not keeping pace with rising health care expenses. The result is declining operating margins, which is critical be cause that means less capital to invest in employees and physicians, innovation, expansion of services and much more. Approximately 40 percent of California hospitals have negative operating margins. Sharp, like many health care systems over the last four years, has experienced negative pressures on operating margins despite strong year-over-year market share growth. Government payers (Medicare and Medi-Cal) continue to pay less than the full cost of care within our industry, and they are our largest payer.
Q: San Diego is a genomics hub, with companies like Illumina based here. How can hospitals incorporate genomics into care?
A: Genomics is vitally important to our work, especially around perinatology, neonatology and oncology. Working with our internal and external professionals, we incorporate genomics into a number of aspects of care from prevention to screening changes to treatment choices. Detection of a harmful inherited genetic mutation can identify care management changes such as preventative surgeries or changes in the frequency or modality of screenings to detect cancers earlier. Genomics can be used in selected cases of cancer when targeted treatments are available. Highly selective drugs combat the disease when the presence of a specific configuration or target has been detected using genomic testing.
Q: How might your hospital be using telemedicine to gain a competitive edge?
A: Sharp was an early adopter of telehealth and telemedicine, and we are committed to using the technology to its full capacity to provide care to our patients throughout the care continuum in the ambulatory, acute-care and post-acute care settings. Through telemedicine at Sharp, patients can schedule a video visit with their primary care doctor or have an “e-consult” with a specialist such as a dermatologist. And in the emergency room, telemedicine makes it possible to conduct remote assessments of behavioral health patients and treat stroke patients. In sum, telemedicine a cost-efficient and convenient way for patients — consumers — to access timely care.
Q: Any thoughts on how a hospital of tomorrow might interact with its community? Will it be much different than today?
A: Hospitals and health systems have always been, and will continue to be, important community partners. Systems need to expand partnerships across their communities and collaborate as appropriate with other care providers to share information and ensure a seamless transition of care for patients. A major area of focus will be working with partners on social determinants of health to find solutions to or mitigate issues such as homelessness and food insecurity. Progress can only be made by casting a wider net with key organizations, such as 2-1-1 San Diego, to realize effective solutions.
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