Q&A: ‘Coordinated 
care is the 
best care’




, Q&A: ‘Coordinated 
care is the 
best care’

Kevin Mahoney has served as CEO of the six-hospital College of Pennsylvania Well being System based mostly in Philadelphia since July 2019, a part of a 23-year management profession at Penn Medication. Mahoney lately talked with Assistant Managing Editor David Could about classes discovered within the combat in opposition to COVID-19 and a few coverage priorities for President-elect Joe Biden. The next is an edited transcript.

MH: With the COVID surge in current weeks, what’s completely different in contrast with the primary wave? What have you ever discovered?

Mahoney: At Penn, we’re again to our early June numbers, as we got here down from our peak COVID census within the springtime. What we did in the course of the summer time was a number of desktop planning for if the virus got here again, how would we coexist with it at 10% quantity, 30% quantity, 40% quantity of COVID sufferers.

We don’t wish to shut down care to non-COVID sufferers like we did again in March as a result of we now have various documented circumstances of sufferers that delayed care, deferred care or weren’t capable of obtain care. And their illness, whether or not it was superior most cancers or cardiology, progressed quicker than it will have if that they had acquired well timed care.

Within the desktop evaluation, we now have a scoring system for surgical procedures. It permits us to take a look at the subsequent three to 4 days of surgical procedure and stability the sources these sufferers would possibly want. For instance, ICU beds. We have a look at our sources versus the power to defer care. So some would possibly get deferred to launch the strain for the uptick in COVID circumstances.

One thing else we discovered confirms Dr. (Anthony) Fauci’s assertion early this 12 months—that people don’t decide the virus’ timeline, the virus does. It has been unpredictable because it’s made it’s approach by Philadelphia and again once more. And now it’s been an extended haul, attempting to make it possible for we defend the behavioral well being and well-being of our staff. 

MH: Dr. Fauci has been speaking about subsequent spring or summer time because the earliest for return to any sort of normalcy, relying on the vaccines. What are the challenges?

Mahoney: At Penn, we’re very proud that two of the vaccines which have proven promise to date are constructed on Penn know-how. Dr. Drew Weissman, an immunologist on the College of Pennsylvania, developed the mRNA vaccine know-how that paved the best way for Pfizer’s COVID-19 vaccine.

However distribution of the vaccines can be an infinite problem. It’s one factor to create it, however getting it distributed throughout the globe is popping into the principle problem. So I believe Dr. Fauci and others are speaking about late summer time, fall. Possibly even to start in 2022 earlier than we see normalcy.

One other factor that was necessary to us as a lesson, going ahead, we have to get larger as a well being system. We want managed-care contracting energy and issues like that.

And one factor we discovered from COVID’s arrival within the spring is the need for a multihospital system to be tightly, clinically built-in. As we had our first surge of sufferers by Princeton Medical Middle (in New Jersey), it wasn’t simply Princeton taking it on; all of the critical-care medical doctors throughout the Penn system rallied to assist them out, and classes from Princeton had been utilized throughout the opposite hospitals. We actually noticed the worth of a well being system, from an financial vantage level and a medical vantage level.

MH: Penn Medication had already rolled out telehealth capabilities earlier than the pandemic, appropriate?

Mahoney: Completely. I’m going to steal a line from Mauro Guillen, a professor of worldwide administration on the Wharton College and an in depth colleague of ours: “COVID didn’t create a brand new regular.” I imply, how might you might have a traditional in a pandemic? What COVID did was it accelerated developments that had been already underway. So the a whole bunch of thousands and thousands that we invested in digital well being earlier than March got here into play as a result of we had been capable of rapidly pivot virtually seamlessly to treating sufferers just about.

We didn’t begin in March. We already had the platform. We had been at greater than 207,000 telemedicine visits on the finish of April, about 340,000 by the tip of Could, and over 750,000 telemedicine visits in early November.

MH: Do you suppose sufferers will proceed to embrace telehealth post-pandemic?

Mahoney: For certain sufferers will embrace it; our physicians and employees will embrace it. I believe the necessary factor from our perspective is coordinated care is the most effective care. So utilizing the digital well being document, utilizing a community of physicians that know one another. Versus episodic care, coordinated care is far inexpensive and the outcomes are considerably higher. We see digital well being and telemedicine as one other device within the toolkit. Nevertheless it doesn’t stand alone.

MH: What are some points you wish to see excessive on President-elect Joe Biden’s healthcare agenda? 

Mahoney: Issues that enhance entry to care must be excessive on the agenda. The limitations to entry and entry present the racial divide, the digital divide in telemedicine. I’m searching for issues that will simplify healthcare entry so sufferers can entry it extra effectively and it wouldn’t value a lot.

An instance: I’ve 44 full-time-equivalent staff doing nothing however pre-certifying X-rays. And that’s condensed to roughly $four.four million a 12 months of spending simply to course of paper. I’d a lot somewhat us provide you with a system that’s a lot less complicated in order that we might redeploy these 44 folks in affected person care.

I’m a believer within the public possibility. … That’s not in style with a number of my colleagues, however I believe it’s the correct factor for America to do. After which drug pricing actually stays high of thoughts for everyone. 

Lastly, from a company that has spawned over a dozen Meals and Drug Administration approvals within the final three years, I hope we get again to an FDA that’s evidence-based and science-based and helps us deliver these novel therapies ahead that may actually change 
the world. 

MH: Are you assuming the
 ACA goes to outlive in 
the Supreme Courtroom’s determination subsequent 12 months?

Mahoney: I very a lot consider the ACA will survive the newest Supreme Courtroom problem. What stays to be seen is what govt orders, tweaks and different issues might be made. 
What can the brand new 
president do on his personal and what does he want Congress for? And I’m hoping that he chooses to work carefully with Congress so we will break down a few of the divisiveness that presently exists.