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Published on July 23, 2020

Mike Lauf, president and CEO of CCHC, shares his perspective on the current environment and our pathway forward

Things we can control at CCHC

As we reflect on the first half of 2020, we realize what an extraordinary year it has been. The COVID-19 pandemic is a once-in-a-lifetime occurrence and has called on all of us to respond in ways we never imagined. The pandemic has forced us to alter the way we do things in our everyday lives, both personally and professionally, and we now know that many of these changes will be with us for a very long time, if not permanently.

These changes have been unsettling and confusing at times, causing us to feel a loss of control. However, we have learned that there are many things we can control, and that is where Cape Cod Healthcare (CCHC) will place our focus going forward. We can and we will get through this health crisis together.

The Current Situation

First, let me tell you where we are with respect to the COVID-19 outbreak. As mentioned in a July 17 update, while we continue to see an increase in coronavirus infections across the country, here in Massachusetts the spread has slowed considerably. On Cape Cod, as the size of our population has tripled this summer, we have not seen an increase in the number of infections. We currently test about 220 people per day, up from an average of 175 per day in June. The average daily positive infection rate continues to hover at 1.4 percent, a figure that has held steady for the past four weeks. In short, we are testing more and seeing the same low degree of positivity.

We currently have testing sites at Cape Cod Hospital (recently moved from Cape Cod Community College) and on the campus of Falmouth Hospital. We are also testing symptomatic patients in our emergency centers prior to all admissions, as well as testing patients who are having surgical procedures. We currently have one COVID-19-positive patient in the hospital.

Patients with COVID-19 who need hospital care are admitted to negative-pressure floors/rooms and are cared for by our exceptional and dedicated staff. We continue to maintain the most up-to-date treatments and protocols, whether it be in our intensive care settings or on the medical/surgical floors.

As the volumes continue to increase in our emergency departments this summer, I want to assure you that we have the appropriate and necessary measures and protocols in place to maintain the highest degree of infection control, quality and safety standards.

Impacts and Lessons Learned

We are continuing to deal in real time with this pandemic, and we are also assessing how it has affected our healthcare system.

COVID-19 has taken a toll on the CCHC system. We know that, year to date, our volumes are down 10 percent in inpatient numbers. We're down 15 percent in the ER. We're down 15 percent in surgery. We're down 20 percent in diagnostics, and 17 percent in our ambulatory division. The decrease in utilization has been much more profound during the COVID pandemic with each of the aforementioned areas losing greater than 20 percent the last four months. Losses continue to mount and, while some aid has come, it clearly isn't enough to get us back to where we used to be.

These are figures we have not seen in many years. Cape Cod Healthcare is not immune to the pressures created by this disease. We now know that we no longer can look and see two and three and four years ahead because we have learned that, in an instant, unforeseen challenges can arise. We must be nimble enough to meet them, while continuing to provide the absolute best care for our patients.

The fact is that the future state of Cape Cod healthcare is going to look an awful lot like our current state. We have learned that we must change. We have learned that people want less, more efficient healthcare. We have learned a new way of delivering care. We have learned that we need to look for opportunities to ensure that we have the right service offerings, and the right investments.

We also have to make sure that we give careful, careful consideration to what we can and can't do well. We have to make sure we grow in ways that are systemic and have the right integration as a system. We must make sure we are clinically and operationally aligned, and that we work to create a more efficient care delivery model. And we know we must look for ways to partner with others – as we have done with Dana-Farber Cancer Institute and UMass Medical School - to improve the care we provide.

The Roadmap for CCHC

Lessons learned:

  • We must be nimble enough to meet unforeseen challenges, while continuing to provide the absolute best care for our patients.
  • We can do more with less.
  • People want more efficient healthcare.
  • We can deliver care in new ways.

Moving Forward, we will ask ourselves:

  • Can we enhance access to care for our population?
  • Can we leverage technology?
  • Can we anticipate our community’s needs?
  • Can we identify new opportunities to provide the right service offerings and partnerships for our community?

How We Move Forward

But it's not all doom and gloom. Going forward, we will look very different from what we looked like at the beginning of March of this year, but there are opportunities that give us a chance to make this healthcare system better in every way. We will look for each and every one in order to maintain the high quality of care our community has come to expect.

We will continue to understand and review all of our relationships. We will continue to work with our physicians, so we can be more efficient, and ask ourselves: Can we create better access to care for our population and perhaps do so in different ways. Can we leverage technology? Can we anticipate our community’s needs? Do we have the right mix of clinical offerings?

Internally, we will look at every aspect of our operation to ensure that from top to bottom, bottom to top, we are efficient. We will examine what is necessary to maintain our high quality of care.

We are committed to the implementation of the Epic electronic health record system this year. This will improve our delivery of care, increase access to health information and make CCHC more efficient in the process. Our go-live date is still set for Nov. 1, 2020, and we have adapted training to ensure safety for all staff members. We have to take advantage of this state-of-the-art EMR, and the simple fact is we have to do better than we've ever done in the past. We must commit to doing things differently.

We have placed the new Tower project at Cape Cod Hospital on hold, as we continue to experience the financial fallout from this pandemic, as well as diminished patient demand. We will revisit it as things improve in the future.

Commitment to Our Community and Staff

Until there is a vaccine developed, we will be living with COVID-19. But, by planning appropriately and wisely, we can get through this in a way that preserves this community’s health system. We can invest smartly; we can stop the duplicity; we can improve the outcomes of the care we provide.

When this pandemic is finally behind us, we certainly won't look like we did before. We may come out of this with some bruises and some scrapes, but we can emerge as a different, better health system. No matter what, our ongoing commitment to quality, to doing whatever is necessary to take care of our community and our employees, will absolutely always remain the same.

We have learned a great deal from the COVID crisis and we will use these lessons to preserve the incredible resource that this community deserves. With your help and commitment, we will continue to provide the highest quality, most accessible healthcare in Southeastern Massachusetts. Thank you so much for all you do.