Hospital systems are taking the first steps toward reviving elective procedures that have been canceled due to the COVID-19 pandemic, but major concerns about safety and patient confidence remain.
Executives with multiple health systems said they are getting closer to restarting the elective surgical procedures that are so vital to hospitals’ financial bottom line.
But hospitals need to not only get consumers comfortable with even heading to the hospital, but also need to “ensure that we can provide that care safely and still have the adequate supplies to care for the virus,” said Cindy Clemence, chief financial officer of Trinity Health, a nonprofit Catholic health system comprised of 93 hospitals spread across 22 states.
Clemence told FierceHealthcare the system is preparing some of its hospitals for resuming procedures.
“We will do that market by market,” she said. “Certainly we are working towards some of our hospitals being able to begin doing that in May.”
Trinity Health, like many health systems across the country, has faced plummeting revenues as patient volume has also declined. The system has furloughed 2,500 workers out of its 125,000 staff.
States on the East Coast such as Maryland and Massachusetts are still seeing surges, but COVID-19 cases have stabilized in others such as Michigan.
The Trump administration sent out a guideline for states to reopen certain businesses, and several states such as Texas and Georgia have allowed procedures to resume. The Centers for Medicare & Medicaid Services (CMS) has also released a guidance on how to restart procedures, with testing and personal protective equipment (PPE) availability a vital pillar of any plan.
Trinity is exploring creating zones of care that would safely segregate patients and physicians from COVID-19 cases.
Ohio State University Wexner Medical Center announced earlier this week it is also slowly resuming elective procedures. Medical staff are going to start to check in with patients in the coming weeks if their procedure was postponed and schedule a telehealth appointment, according to a release from the university.
During that appointment, a patient will speak with their provider about the state of their condition and risks surrounding the virus.
“Together, they’ll come to a joint decision about moving forward with the procedure,” the release added.
Patients could be tested for COVID-19 to help determine their risks to other patients and staff, but if a positive test result comes back it “doesn’t necessarily mean they won’t be scheduled,” Wexner said. “They may need to wait longer, if possible, to have their procedure.”
It will be important for hospital systems to even reassure patients it is safe to get their surgery and even go to a healthcare facility, said Benjamin Domb, founder and orthopedic surgeon at American Hip Institute & Orthopedic Specialists.
Physicians and surgeons will need to provide guidance on the risks of delaying their procedure, and "allow the patient to make the decision that is right for them," he told FierceHealthcare. "While concern about contracting COVID-19 is extremely valid, patients must also understand that with some procedures, further delay may render their injury irreparable."
North Carolina-based WakeMed Health & Hospitals created a command center task force that dealt with the outbreak.
While at first it was convened to plan for any surge of COVID-19 cases, a large part of the task force has now morphed into business continuity, said Rick Carrico, CFO of WakeMed.
As a good example of how things are changing, WakeMed initially put up tents to screen and test patients for COVID-19.
“We are in the process of dismantling the tents and trying to get regular surgeries back on our schedule starting next week,” Carrico told FierceHealthcare.
A major concern for the system is to preserve the amount of PPE, a massive issue for providers during the ramp-up of COVID-19 cases.
WakeMed was able to backfill its need for PPE “because surgeries were down and didn’t need isolation gowns over there,” Carrico said.