MACOMB — The McDonough County District Hospital is looking into some innovative solutions to meet its need for round-the-clock access to physician specialists.
During its regular meeting Monday night, MDH President and CEO Kenny Boyd spoke about how MDH is trying to meet a common challenge of rural hospitals: providing consistent access to physician specialists.
Dr. Richard Iverson led the meeting due to the absences of Chair Kent Slater and Vice President Crystal Bedwell.

Telecommuting and technology
Boyd is meeting next Friday with the SIU Springfield School of Medicine to discuss health needs and opportunities as identified through a survey process. The opportunities discussed included the possibility of doing outreach clinics with SIU, telemedicine, and Electronic Intensive Care Units.
The recommendations reflect an ongoing need for better access to providers and specialists, a common challenge in rural communities.
Outreach clinics, which are run by hospital doctors who make regular visits to primary care settings to see patients, are a boon to patients who may not have access to a nearby hospital. The other options - telemedicine and the EICU - use telecommunications technology to connect physicians, patients, and on-site healthcare workers such as nurses remotely. The uses for the technology range from remote diagnosis to more detailed work such as reading a patient’s chart and even intervention in a crisis.
Some applications of the technologies involve the use of robots in healthcare settings. “InTouch made a presentation about their robot products,” Boyd said. “So we’re in the initial discussion phases to see how that would work to help get access to intensivists is really the goal with that piece.” An intensivist is a critical care physician with special training and experience in treating critically ill or injured patients, and typically works in the intensive care unit of a hospital.
He continued, “…One of the things we’ll always struggle with unless we do something like this is access to intensivists 24/7. That is not a feasible thing for us to have on-site, but EICUs are used across the country, and have been for over a decade.”

Finance Committee Report
Dr. Iverson presented the Finance Committee report. Reading from a prepared summary, he said, “(At) Friday’s Finance Committee meeting, it was decided that the board members preferred detailed discussion of MDH finances to be at the finance committee meeting rather than to have extensive finance discussions at the full board meeting…Our primary role was to make sure that the right kinds of services were being done in the right way and that we would make sure that the hospital remained fiscally solvent so the community would be assured that MDH would be here for the long run.”
He continued. “It’s been my impression that we probably would be better served with a smaller volume of financial data, but a larger amount of what I call ‘relevant soft data.’ What I mean by that is what the senior leadership team thinks the data indicates about the strengths and weaknesses of our organization, and where they see we are, and where they think we need to improve. We also of course welcome information that indicates we are on target with our mission and vision. In other words, there is as much value in the opinions of the leadership team as in the data itself.”
The finance committee will be meeting in February to prepare materials “with these ideas in mind,” he said, and asked members of the board to provide their feedback on the ideas and materials.
Linda Dace, vice president of finance at the hospital, added her comments to the report. “As you saw Carissa (Kinman)’s report on the ACO (Accountable Care Organization), one of the things we’ve identified are a reduction in the budgeted volumes — anticipated volumes — particularly through the ED (Emergency Department),” she said. “Over the last couple of years, we had seen a pretty sharp increasing trend in the number of patients seen in the ED. Certainly our ACO activities have not impacted that as of yet, but we are probably more in line with where we were in terms of average ED visits than we were a couple of years ago.”
The ACO’s goal is to reduce costs to rural hospitals while still providing quality healthcare. One of the ways the ACO attempts to achieve this goal is reducing unnecessary visits to the Emergency Room through the use of trained staff members called Care Coordinators. These staff work with patients who have chronic health issues to get them the most appropriate care, and work toward avoiding health crises through the use of preventive care and early intervention.
“Certainly we’ve also discussed how the impact of the student enrollment at WIU and changes in faculty and how that impacts our volumes. So we will be taking that into consideration as we prepare our budget starting in February going forward.”
With regard to the decision to give less detailed data at board meetings, she said she would be glad to present specific information upon request to maintain transparency.

Updates
Harlan Baker, who works in Information Systems and took on the positions recently vacated by Jack Baily, updated the board on the the electronic health records conversion. He said an “inappropriate set-up” in the pharmacy supply chain set up of pharmacy items and how they’re distributed caused a “financial blip” this past month. He said the issue had been discussed in the finance meeting, and had been addressed.
The OB-Gyn department has had a demonstration of a Cerner module that will bring all of the OB charting from the clinic and hospital into the Cerner application. The integration of all records into one system will allow the OB department to get a better idea of the patient and delivery history throughout the process, Baker said.
The hospital is looking into providing ongoing learning and leadership development opportunities for staff that include eight-minute online training modules from the Rapid Learning Institute, and the possibility of on-site CME (Continuing Medical Education) programs through SIU School of Medicine in Springfield. The CME in particular helps people in the medical field maintain competence and learn about new and developing areas in their field, and some CME providers are accredited organizations. “We have identified some on-site CME programs that we have worked with doctors Carr, Jalil and Minter on for selection,” Boyd said. “So the goal is to schedule two-three of those between now and the end of the year.”
The hospital continues to look for a third OB-Gyn doctor. MDH has been recruiting full-time OB-Gyn providers to provide sufficient coverage and to allow the physicians a healthy work/life balance, which increases the likelihood of retention. Dr. Afriye Amerson, the most recent candidate approved, will be given a welcome reception on Feb. 14 from 2 to 4 p.m. in Auditoriums A and B on the Macomb MDH campus. Amerson’s start date is to be determined, but should be between late January and Mid-February. Similarly, Pediatrics is also looking for a full-time pediatrician or nurse practitioner to improve coverage and provide existing and new staff better quality of life.
The hospital will be evaluating non-labor and labor costs at the end of the month, Boyd said. On the contract side, the hospital will be looking into supply costs to get better deals. With regard to labor, MDH is looking into “where do we have too many resources, not enough resources,” Boyd said. “As the healthcare continuum changes and the healthcare market shifts nationally, not just locally, we’re doing things from not just a reactive industry but a proactive industry.” He said department leaders will be using national, regional and state benchmarks to guide them in staffing their departments and gauging performance.
Air Evac, the air transfer provider, is evaluating the site where they plan to build their base, and is planning construction. The anticipated completion date is set for late June or early July.
The pain management services are attracting patients. The McDonough Medical Group Family Clinic in Health Services Building 2 likewise is also growing and accepting patients. Extended hours for the Family Clinic 7:30 a.m. - 7:30 p.m. and Friday from 8 a.m. - 5 p.m.
An educational program on dementia will be presented by Teepa Snow, an educator on dementia, Feb. 22 and 23 at the Spoon River College Outreach Center, located at 2500 E. Jackson St. The event is free and open to the public, but respondents must RSVP by Feb. 8.
The Feb. 22 program, “Dementia 360 – Seeing it from all Directions,” is from 5:30 p.m. - 7:30 p.m. with doors opening at 5 p.m. It addresses dementia from several different points of view, and provides strategies to meet the needs of affected individuals. A meal will be provided. The Feb. 23 program, “Helping a Faith Community Care for its Members and Families Living with Dementia,” is from 2 p.m. - 4:30 p.m, and is a learning activity focusing on inclusion strategies that help people be a part of the faith community and support one another. Refreshments will be provided.
For more information or to RSVP, call 309-836-1587.

Reach Michelle Langhout via email at mlanghout@McDonoughVoice.com or follow her on Twitter @mlanghout1.