By ALAN J. ORTBALS
Tremendous change is occurring in the health-care industry and one of the biggest is the move to decentralized care. Patients demand it and technology makes it possible. Gateway Regional Medical Center, for example, has been opening a variety of health-care centers and spreading its footprint throughout Southwestern Illinois. It now boasts three imaging centers, a surgery center, a health center that encompasses wound care, a sleep center, imaging and a lab, plus eight clinics where all specialties rotate.
“When I got into health care,” said GRMC CEO Ed Cunningham, “if you had your gall bladder taken out, it was a week in the hospital and then home. Fifteen to 20 years ago we started doing gallbladders laparoscopically and you went home the next day. Now, we do them robotically and you go home that night.”
Cunningham says he sees the transition to outpatient services not only continuing, but accelerating.
“I think somewhere in the future we’re going to see almost everything being done on an outpatient basis,” Cunningham said. “Hospitals will provide ICU care for people who are very sick for a short period of time and then transition people home. Everything else will be outpatient.”
The move to outpatient services in satellite locations, however, doesn’t mean diminished services, says Cunningham.
“Why do you have to see a Board Certified ER doctor if you’ve got the flu?” Cunningham asks. “A nurse practitioner usually receives hospital experience. Most of them have multiple years of ICU training in a hospital before they go to school to become a nurse practitioner. They provide immediate access to care in our urgent care centers and we tie them in to our emergency room so, if there’s a question, we have an emergency room doctor who can assist.”
Cunningham said he thinks the next step will be to telemedicine, which will be particularly useful in rural settings. Medical centers like GRMC have set up clinics in small towns; eventually, people will be able to see a doctor via a computer monitor; the doctor will be able to assess the situation; take care of the problem or order tests if further information is required.
“In the future, 90 percent of health-care issues in a rural setting can be done via telemedicine using technology similar to that of today’s ‘Facetime’ application on an iPhone,” Cunningham said. “For example, in our Urgent Care we have a system set up for radiology whereby we can take an X-ray and have a radiologist look at it within minutes of it being taken. Eventually, you’re going to see the care taken directly to the patients and it will be driven by access and time frames. People do not want to wait.”
Besides the time and convenience factors, outpatient services offer great financial savings as well. Cunningham said that urgent care treatment could be provided for just a fraction of the cost of going to an emergency room.
GRMC used to be considered the medical center for the Granite City area but no longer. Now, Cunningham said, they look upon a 10-mile radius as their primary service area with a secondary service area stretching out 30 miles from the hospital.
“We send our specialists as much as 35 or 40 miles out from our facility to see patients,” Cunningham said, “and we just bought an imaging center in Waterloo, Ill.”
GRMC is not finished growing. Cunningham said there are two or three new outreach centers on the drawing board right now. “We are increasing the number of providers in various locations and hiring more specialists.
“It’s a matter of having the right people in the right places to take care of patient needs,” Cunningham said. “The systems we have available to us allow us to drill down on the demographics and find exactly what’s needed in which areas and why.”
Cunningham says there is only one constant in health care — change.
“I would just say, ‘Stay tuned’,” Cunningham added. “I’ve been in it for over 30 years and every time we think we’re hitting the spot that’s the biggest change that we’ve ever seen, give us a couple of years and we’ll see another one and we’ll say the same thing.”
By ALAN J. ORTBALS