Beyond brick-andmortar
QHow will the continued shift to home and outpatient care change your capital project spending?
Bonick: Telehealth, home health, hospitalat-home—all of those were long needed. I don’t believe the industry by and large needs to add a lot of beds to the system. But we do need to add the technology to be able to care for people in the right place.
The industry has largely been the Field of Dreams: “If we build it, they will come,” and patients came to us because they really didn’t have a choice. COVID has helped provide that choice. And now that people have tasted it, they don’t want to go back to the way things were. We have to embrace that.
The good news is that it’s capital-light, comparatively. We all have these big brickand-mortar facilities that are expensive. They take a lot of upkeep and maintenance, and that’s a real burden. When we’re talking about things like telehealth or hospital-athome, we’re bringing our services to the patient. Finding the appropriate level of care for patients is important, but we’re certainly going to invest in technology because it is much, much cheaper. While we still have to maintain the core tertiary facilities, this will help us extend our capital resources.
Pullin: The key is, what is safe in the hospital-at-home model? Early results say that it is safer: We’re seeing fewer falls. We’re seeing people who are recovering faster. This is also where technology helps.
You’re seeing the growth and expansion of wearables with the pulse oximeter, blood pressure cuffs, EKGs: all of these things we can monitor remotely decrease the reliance on brick-and-mortar [care].
It’s about moving a patient from a high-cost environment to a lower-cost environment. And if you are getting as good or better results, that is the place to be.
As we look at replacement hospitals, we can build fewer beds as we leverage staff through the use of technology.
We have a mobile pediatric unit, which does health screenings and primary intervention for pediatric patients. We have a mobile cancer screening unit, which offers free mammograms and other cancer screenings in the community. We have to be able to take the care closer to where people live and work.
Davidson: We have a home care service. We provide skilled nursing in the home, hospice in the home. We provide durable medical equipment in the home. We also provide our pharmacy services in the home. We’ve had that program for decades. So, how can you virtually help people and deploy technology to meet those needs? We’ve been doing it for quite some time, but for our rural community, the telephone is one of those technologies that we’ve depended on. We are looking at other technologies to help us in this area, but that’s still in development. We don’t know the complete pathway there.
It’s hard to invest when you don’t know how you’re going to pay for that capital going forward. We’ve looked at a few technologies to help our epileptic patients. We looked at a few technologies to help behavioral health, but again, we need to watch what the reimbursement looks like in order to make sure that we can create a sustainable model
n going forward.