The Guthrie Clinic

Guthrie Clinic is a not-for-profit health system designed to offer patients in rural New York and Pennsylvania a full spectrum of health services incorporating primary care, behavioral health services, surgical services, inpatient care and more. And it has implemented artificial intelligence designed to reduce nurse turnover and overtime, improve care quality, cut costs, and improve access to care. THE PROBLEM Guthrie Clinic serves a primarily rural community that covers 9,000 square miles in parts of New York and Pennsylvania. Providing the same level of access to care across such a wide region can be difficult, and that challenge was even greater during the COVID-19 pandemic. During that time, the health system experienced the loss of a lot of its workforce, and it is located in an area where it already is difficult to recruit employees. "As a result, we decided to look at new care models that would allow us to layer on technology to expand access to care no matter where the employees or the patients are located," said Terri Couts, RN, senior vice president and chief digital officer at Guthrie Clinic. "The idea behind this initiative was that, regardless of where the patient was, we had the ability to deliver the right level of care at the right time wherever the patient needed it. "That way, patients wouldn’t have to travel hours to get care or get transferred to facilities out of their communities that would require their families to travel to visit them," she continued. "The bottom line was we needed to rethink our current models and innovate to maximize our resources by using technology and redesigning current processes." PROPOSAL Guthrie Clinic entered the AI space a little hesitantly and wanted to prove out the return on investment. It went with Artisight, vendor of a platform that leverages ambient AI that sees, understands and augments clinical activities in real time by combining computer vision and sensor network technology. "We started with telesitting," Couts recalled. "During the pandemic, we had a hard time covering all our patients with sitters, a safety precaution for patients at high risk of falling. With traditional sitting, you put a person in a room with a patient to redirect the patient to stay in bed, but that takes a lot of resources and takes those extra hands off other bedside care. "This technology is really making a difference for our organization." Terri Couts, RN, Guthrie Clinic "During this time, we were paying a premium for staff to sit with patients and, even then, we still didn't have enough sitters to go around to all the patients," she said. "The costs were soaring." Guthrie Clinic adopted the AI technology to change that 1-to-1 sit to a virtual sitting model to make the ratio 1-to-14, so now one sitter could safely monitor 14 patients. "This project did not include just adding a camera and speaker to the room, but that hardware sat on top of the AI-driven platform," she explained. "If a patient moves around the room, the AI technology in the camera alerts the telesitter there is activity in the room that requires intervention. The telesitter can interact directly with the patient or call an on-site nurse for assistance. "Overall, the technology has allowed us to lift and shift those 1-to-1 sits and allow those employees to be back at the bedside providing direct patient care," she continued. "We document everything and place orders in the EHR so we understand who's taking care of the patients and the other elements related to patient care." MEETING THE CHALLENGE The health system has grown the program into what it calls a "virtual command center." It is a centralized command center that is not attached to any hospital and allows staff to check the pulse of the organization. The center has virtual sitting, centralized transfer center, virtual telemetry monitoring, virtual nursing, and an EICU component. That was established in the last year and the organization is planning to grow the services in the future. "It's really going to be our virtual hub on how we care for patients and manage resources, whether it be beds, staffing or the ability to transfer patients," Couts said. "The command center helps us coordinate everything to have virtual care models working alongside daily operations and collaboration in the same space. We’ve also integrated the technology with our hands-free communication devices." RESULTS Guthrie Clinic has virtual ICU nurses supporting nursing care at the facilities. After the pandemic, it was at an average of three to five years of seniority in the ICUs, which is critical. "The intuition that nurses have on how to take care of patients was lost because we had a large exodus of nurses," she recalled. "With this technology, we’ve been able to reduce our turnover rate to about 13% from more than 25%. This reduction in turnover also provides cost savings in the form of signing bonuses we would pay out for new staff. "We have been able to look at metrics surrounding how much time per shift nurses are spending in the EHR system," she continued. "These administrative tasks add to the burden and burnout nurses feel. With this technology, we’ve been able to reduce time spent in the system from around 160 minutes to 126 minutes for a savings of more than 30 minutes per shift. That’s a big difference that’s important to our nurses." These types of results illustrate why nurse satisfaction is through the roof, she emphasized. "Additionally, we’ve reduced nurse travelers by 82 for fiscal year 2023," she reported. "That’s a hard cost savings of approximately $7 million. Our ICUs no longer have travelers. Travelers serve a specific purpose but are not a sustainable long-term model for two specific reasons: costs and engagement with the organization and patients they serve. "We’re also measuring things like how many transfers we’ve accepted from outside organizations," she noted. "We were losing about 50 transfers a month because we didn’t have the right support. Now, thanks to this technology, we are able to accept those patients, which also adds to our bottom line." The other thing the health system is measuring is quality outcomes, such metrics around sepsis and making sure the organization is staying within sepsis bundles to ensure it can receive the reimbursement it deserves for the work it performs. "Our virtual nurses are like a director of an orchestra," she explained. "They help ensure documentation is done in a timely manner and that fallouts in the bundle are minimized by ensuring the time-driven tasks are completed. "This technology is really making a difference for our organization, and we’re getting third-party validation of its importance," she continued. "We are proud to have won the ECRI 2023 Health Technology Excellence Award for the implementation of AI-driven telesitting." ADVICE FOR OTHERS "AI is a huge buzzword right now, and there are many vendors that have AI-like products," Couts said. "Before adopting anything, it’s important to identify the problems you are looking to solve and understand if the technology can help you address more than one use case. "In a world where healthcare is financially challenged, as we embrace AI products, healthcare technology leaders need a vendor that partners with you to address all the challenges that we face," she continued. Today Guthrie Clinic is endeavoring to add on technology where its EHR has gaps, and one of those technologies is AI. "So, we've layered on the AI suite, and it is a true platform that will allow us to scale in the use cases that we need," she said. "In our case, we had such a large workforce exodus that virtual nursing and sitting were the most pressing needs. "We were able to do that pretty seamlessly and then move onto other use cases, such as protecting staff from violence," she concluded. "It’s very important to not only understand what your use case is today, but also where you want to go in the future so you don’t get stuck with a platform you can’t optimize. The system we’ve implemented is truly a comprehensive smart hospital platform." Follow Bill's HIT coverage on LinkedIn: Bill Siwicki Email him: bsiwicki@himss.org Healthcare IT News is a HIMSS Media publication.

Healthcare mergers and acquisitions are in no short supply as providers, payers, health tech companies and other industry players look to expand their businesses and gain a competitive edge. Healthcare mergers and acquisitions are in no short supply as providers, health tech companies, payers and other industry players look to expand their businesses and gain a competitive edge. Here’s a roundup of new deals that were revealed, closed, rumored or called off during the month of June. Provider Amedisys, a large home health, hospice and palliative care provider, agreed to be acquired by UnitedHealth's Optum in a $3.7 billion all-cash deal that scraps a previous all-stock option from Option Care Health. Amedisys had previously agreed to the Option Care acquisition in May before receiving the unsolicited offer from Optum. As a result, Option Care will receive a $106 million termination fee. Should the new deal close, Optum would add about 18,000 home health employees and 522 care centers to its growing collection of home health offerings. UPMC signed a nonbinding letter of intent to affiliate Washington Health System, a two-hospital nonprofit community health system based in Pennsylvania. Washington Health System had been on the hunt for a larger health system to partner with and reportedly turned down an offer from Highmark Health’s Allegheny Health Network. UPMC and Washington will be hashing out the terms on a definitive affiliation agreement “over the next several months” in a deal that would be subject to customary regulatory filings. Other potential terms were not disclosed. Vandalia Health (the recent combination of Mon Health System and Charleston Area Medical Center Health System) signed a nonbinding letter of intent to acquire Davis Health System, which includes an acute care hospital, two critical access hospitals and other specialty care facilities serving West Virginia’s Potomac Highlands region. Terms and an estimated timeline to close were not shared in the announcement. Beth Israel Lahey’s acquisition of Exeter Health received an all-clear from the New Hampshire attorney general’s office, paving the way for the deal to go live July 1. The merger was announced in June 2022 and adds the 2,500-person, single-hospital Exeter to the 13-hospital Beth Israel Lahey. Parkview Health System (PDF) wrote in an event filing that it plans to acquire Community Hospitals and Wellness Centers, an Ohio-based nonprofit system with two hospitals and a medical center hosting several outpatient clinics and same-day surgical services. Parkview said it expects to close the acquisition Sept. 1.   Boston Children’s Hospital and pediatric post-acute care provider Franciscan Children’s announced in late June a definitive affiliation agreement that closed July 1. The deal sees Franciscan Children’s retain its branding as a “sister hospital” to Boston Children’s, though it will now be under the umbrella of Boston Children’s parent organization, Children’s Medical Center Corp. The affiliation allows Boston Children’s to begin offering more integrated care offerings related to behavioral health and rehabilitation and paves the way for hundreds of millions of investments into Franciscan Children’s facilities and staff. Novant Health’s plan to purchase and invest $50 million into the struggling Pender Medical Center in North Carolina was approved unanimously by the Pender County Board of Commissioners. Novant had been operating the facility since 2021 under another agreement but now will work to develop Pender Medical Center into a community general hospital over the next 10 years. Legal documents will be finalized in September, and the deal will be closed in six months, the board said. The Guthrie Clinic is purchasing ownership of Our Lady of Lourdes Memorial Hospital and its related locations and practices from Ascension. The deal is expected to close by early 2024. Christus Health announced it would acquire New Mexico-based Gerald Champion Regional Medical Center, a sole community hospital in New Mexico. The deal went into effect July 1. University of Missouri Health Care has signed a nonbinding letter of intent to fully integrate with Capital Region Medical Center. The pair had been partners for more than 25 years and said they expect to finalize their arrangement by the end of the year. Adventist Health reportedly acquired the struggling Bakersfield Heart Hospital in California for “a nominal sum.” The hospital had been independently owned by local physicians that, due to pandemic financial struggles, had laid off 114 employees last fall. Adventist leadership reportedly said its purchase will save 300 jobs at the facility.   Atlus Community Healthcare—a portfolio company of ZT Corporate, a private equity firm—acquired Exceptional Emergency Center. The purchase of Exceptional and its 14 free-standing emergency rooms now brings Atlus to 30 such facilities in Texas. Inova Health System has picked up Northern Virginia Pulmonary and Critical Care Associates, a nine-physician group, for an undisclosed sum. With the deal, Inova created a new pulmonary division and added two practice locations to its tally. Payer Bright Health is selling off its California plans, the last of its insurance businesses, to Molina Healthcare for up to $600 million in cash. The insurtech had been selling off its pieces in a push to raise capital and stave off bankruptcy. For the deal to go through, however, Bright must remain solvent through the first quarter of 2024, which will likely require a bridge loan. Bright Health has roughly 125,000 members covered through Medicare Advantage prescription drug plans, dual eligible special needs plans and chronic conditions special needs plans across 23 California counties. Centene closed its previously announced divestiture of artificial intelligence platform Apixio to venture capital firm New Mountain Capital. Financial terms of the deal were not disclosed, though Centene said it expects the deal to be earnings neutral for 2023. The government insurance giant had acquired Apixio in 2020 but has been reconsidering its portfolio as part of a broader value creation plan. CareSource, a nonprofit health plan with over 2.3 million members, said it has an agreement in place to acquire Metta Healthcare and United Church Homes. The latter organizations will form a new nonprofit entity named Radiant Alliance, which will become an affiliate of CareSource and serve as its innovation platform piloting supportive care and housing capabilities for aging members with complex medical needs. Terms of the deal were not disclosed.   Health tech Thirty Madison scooped up the assets of recently bankrupted online birth control and telehealth company The Pill Club in a deal valued at $32.3 million. Thirty Madison, a virtual-first health clinic offering telehealth visits and online prescriptions, said the deal strengthens its position in women’s health. Cardinal Health announced a deal that merges its Outcomes business, which includes an ecosystem of patient engagement, clinical care, workflow and financial tools for clinical pharmacies, with Transaction Data Systems, which has its own portfolio of clinical pharmacy solutions, in exchange for a minority stake in the combined entity. The deal is expected to close in the third quarter of 2023 and would create an integrated pharmacy workflow software offering. Miscellaneous Premier Inc. signed a definitive agreement to offload its non-healthcare group purchasing operations to OMNIA Partners for about $800 million cash. The deal aims to satisfy stockholders after sequential tough quarters and allows Premier to focus its attention on growth in its core healthcare business. The deal is expected to close in early August subject to regulatory approval and other conditions.

Over 500 year-end grants will address the health-related needs of low-income and underserved New Yorkers, including food insecurity, education access, the mental health crisis, healthcare workforce development, and social services for incoming immigrants and migrant workers NEW YORK, Jan. 23, 2023 /PRNewswire/ -- The Mother Cabrini Health Foundation today announced it has awarded 538 grants totaling $165 million to support nonprofit organizations addressing the health-related needs of low-income residents and underserved communities across New York State in 2023. In the four years since its inception, the Foundation has now awarded approximately 2,200 grants totaling nearly $635 million. Newly funded grantee initiatives will target New York's evolving needs by expanding access to food, education, support for mental health, as well as access to healthcare and social services. Grant recipients include community-based organizations, food banks, healthcare providers, nursing homes, schools, federally qualified health centers, and trade associations addressing the needs of key populations: low-income individuals and families; older adults; youth and young adults; persons with special needs; immigrants and migrant workers; veterans; formerly incarcerated individuals; and young children, pregnant women, and new moms. Efforts will address urgent challenges including New York's healthcare workforce shortage and current migrant crisis. Over 60 grants totaling $17 million will support immigrants and migrants fleeing violence and persecution in their home countries and those encountering significant challenges upon arrival to the U.S., a roughly 30% increase in funding from the previous year. In addition, 55 grants totaling $14 million will allow organizations to focus on recruiting and retaining a diverse workforce, especially as the state continues to face an urgent shortage of nurses and healthcare practitioners. "At a moment when New York State's health needs are both acute and wide-ranging, the Foundation is supporting hundreds of programs addressing the needs of vulnerable New Yorkers and underserved communities across the state. From building up our healthcare workforce and providing essential resources for immigrants and migrants, to investing in community-based providers that address chronic challenges from mental health to food insecurity, funding this year will again offer much-needed support to underserved communities," said Alfred F. Kelly, Jr., Chairman and Chief Executive Officer of Visa and Chair of the Mother Cabrini Health Foundation Board. "When Mother Frances Cabrini arrived in New York as an Italian immigrant in 1889, she dedicated herself to serving fellow immigrants and underserved New Yorkers. This year, New York has welcomed tens of thousands of new immigrants seeking a new home, and the Foundation is proud to follow in our namesake's footsteps by increasing our support for nonprofits helping immigrants and migrant workers. As the needs of New Yorkers continue to evolve, the Foundation is committed to ensuring our grants have the greatest impact possible," said Msgr. Gregory Mustaciuolo, Chief Executive Officer of the Mother Cabrini Health Foundation. "In our fourth year of grantmaking, the Foundation continues to support nonprofits with whom we have established long-term partnerships while also uplifting new, innovative programs. In every corner of the state, our grantees tirelessly serve their communities while mitigating impediments around social determinants of health and breaking barriers to improve health outcomes," said Kathryn Ruscitto, Chair of the Mother Cabrini Health Foundation's Regional Grants Committee. The Foundation's new round of grants include: $22 million toward expanding educational opportunities as a pathway for economic mobility, including a grant to BISON Children's Scholarship Fund to support scholarships for thousands of low-income, K-12 students in Western New York, as well as a grant to the Thrive For Life Prison Project to expand support for formerly incarcerated individuals pursuing college and career training programs. $15 million toward fighting increasing food insecurity in New York, including a grant to the Met Council to support its food distribution network including a mobile pantry and home delivery program, as well as Capital Roots to provide holistic food access to low-income residents of the Capital Region. $14 million toward increasing mental and behavioral health services, including a grant to the Asian American Federation to expand access to linguistically and culturally competent mental health services for Asian communities across New York State, as well as to Covenant House New York to provide mental health services for homeless youth and young adults. $14 million toward workforce development to expand the healthcare workforce and job opportunities for low-income New Yorkers, including a grant to Upwardly Global to help immigrant and refugee professionals secure thriving-wage employment commensurate with their training and education, and Niagara University to help support nursing students and increase nurse retention. $9 million toward increasing access to healthcare resources, including a grant to the Community Service Society of New York for an outreach campaign to inform low-income New Yorkers about the end of the COVID-19 Public Health Emergency and resulting changes to their healthcare coverage, as well as a grant to Westchester Institute for Human Development to provide mobile primary care for individuals with disabilities. $7 million toward improving access to quality long-term care for older adults and New Yorkers with long-term disabilities, including a grant to Loretto Health and Rehabilitation Center for capital improvements to strengthen the behavioral safety net for older adults with dementia in Central New York, as well as a grant to ArchCare at Ferncliff Nursing Home and Rehabilitation Center for the establishment of the Center for Advanced Memory Care for adults with neurodegenerative disease. $84 million toward addressing other critical health needs, including care and case management, housing assistance, child and family wellbeing, community health, healthcare system improvement, home care, community health, legal services, medical and rehabilitation services, and early childhood and youth development. In 2020, the Foundation launched an initial round of strategic grants to provide three years of sustained funding for identified areas of need. The year-end 2022 grants include $13.6 million to expand the Foundation's strategic grants focused on three areas: a third year of grants to increase access to oral healthcare services, a second year of grants to address early childhood disparities in maternal and infant health outcomes, and a second year of grants to mitigate healthcare disparities by diversifying the healthcare workforce. Strategic grants include: $6 million to increase access to oral health services through grants that will provide specialty dental care for New Yorkers with intellectual and developmental disabilities, and mobile dental health vans that will reduce barriers to accessing care. Grantees include the Buddhist Tzu Chi Medical Foundation in Queens and the University of Buffalo's UB S-Miles To Go program. Across the three years of funding, the Foundation has awarded 35 oral health strategic grants totaling $15.2 million. $3 million to address early childhood disparities in maternal and infant health outcomes with grants focused on maternal health and wellbeing. Grants support mental health programming and culturally informed interventions for asylum-seekers, survivors of trafficking, and recent immigrants. Grantees include Montefiore Health System for its Terra Firma Project, and InterFaith Works of Central New York. $5 million to mitigate healthcare disparities by diversifying the healthcare workforce by funding programs to grow and support the workforce, and through scholarships and fellowships to change the faces of New York's healthcare delivery system to better reflect those it serves. Grantees include the Associated Medical Schools of New York and the Hunter College Foundation for its Cabrini-Hunter Fellowships for Social Work and Nursing Students. "The Foundation's strategic grants dedicate long-term resources to key issues affecting health equity in New York. Three years of funding for oral healthcare initiatives has had a positive impact for underserved New Yorkers, especially in rural areas, while helping to bridge the gap in systemic barriers to healthcare," said Kathryn Connerton, President and CEO of Lourdes Hospital in Binghamton and Chair of the Foundation's Statewide Grants Committee overseeing strategic grants. In spring 2022, the Foundation invited organizations to apply for funding through an open process, receiving over 1,500 letters of interest, both from returning grantees and new organizations. Approximately 46% of the grants were for $250,000 or more. Click HERE for a list of year-end 2022 Mother Cabrini Health Foundation grantees. About the Mother Cabrini Health Foundation The Mother Cabrini Health Foundation is a private, nonprofit organization whose mission is to improve the health and wellbeing of New Yorkers, bolster the health outcomes of vulnerable communities, eliminate barriers to care, and bridge gaps in health services. Named after a tireless advocate for immigrants, children, and the poor, the Foundation funds programs and initiatives across New York State that provide either direct healthcare services or address the social determinants of health. For more information, visit Media Contacts C.J. Mayer, [email protected], (917) 428-1236 Bob Varettoni, [email protected], (917) 734-4156 SOURCE Mother Cabrini Health Foundation