We all know the right things to do to keep healthy and unfortunately, we tend to push them to the side when it comes to protecting ourselves.

In a recent article that I just read on improving our immunity levels, their advice sounded like the same advice that my mother used to share over the 70 years that I know her. To quote the Buck Institute, that advice includes:

  • “Nutrition: Fruits and vegetables have thousands of active compounds that help support immune strength. Diets high in fruits and vegetables, and low in simple carbohydrates, can also help retain insulin sensitivity and promote metabolic health. In particular:

– leafy greens contain iron, folate, and Vitamin C

– carrots and sweet potatoes are high in Vitamin A

– bell peppers and citrus are very high in Vitamin C

– nuts, lentils, and seeds (as well as meat and oysters) are a good source of zinc, which helps support immune function

  • Exercise: One small study found that older adults who exercised vigorously had immune systems similar to those of much younger adults.
  • Sleep: This might be hard for many of us right now. Stress and disrupted routines can make it hard to relax at night, but it’s worth trying some advice from the Mayo Clinic to get better sleep. New data is finding that irregular sleep patterns are associated with increased risk of metabolic disorders and obesity (at least in worms). And remember, a well-rested body supports a well-rested immune system.”

As we read and hear more discussions about personal accountability, it is likely only a matter of time before insurers link health insurance premiums to how well we take care of our own bodies.

Is 2024 not the year for you to wake up and heed the advice of your parents and grandparents to eat properly, get exercise, and get plenty of sleep? Start today.



BY: Jaime Caldwell, President of SFHHA

It has been a pleasure being with you over 2023.  Once a month, I have gotten the opportunity to share some thoughts with you about what’s happening locally and, more generally, in healthcare overall.

There will be one more opportunity to share with us this year and that will be on December 7th at the Signature Grand in Davie.  This is our annual meeting and dinner where we recognize our current Board members and ask you, our members, to support our changes in leadership for 2024.  You can go to our website (www.SFHHA.com) and click on our events tab to register to attend.

At this time of year, it is nice to take a breath and ask, “Where are we going?”  So, here is my view.

The future of hospitals in providing healthcare will be marked by a dynamic shift toward a more patient-centric and technology-driven approach.

As the traditional healthcare paradigm shifts, hospitals are anticipated to play a central role in integrated care systems, fostering collaboration among various healthcare entities.  (Moving forward, patient care must be more than just the treatment of episodic care.  Rather, we must do a better job to holistically care for these patients by more efficiently coordinating their totality of care.)

Patient care will increasingly extend beyond traditional hospital settings, with a focus on preventive measures, outpatient services, and community-based initiatives.  Telemedicine and remote patient monitoring will become integral components, allowing hospitals to reach a wider demographic and provide ongoing care.

Moreover, advancements in data analytics and artificial intelligence will enhance diagnostic accuracy, personalized treatment plans, and overall operational efficiency.  Hospitals will likely serve as hubs for innovation, research, and medical education, fostering a culture of continuous improvement.

So, as we move forward, embracing these changes will be crucial for member institutions to allow them to remain at the forefront of delivering comprehensive and accessible healthcare services.

The next ten years will be amazing!

 



Leading into, during, and now post pandemic, hospitals have been on a financial rollercoaster.

Higher hospital operating margins in 2020 and 2021 have given way to the new realities in 2022. Inflation, the higher cost of goods and services, and higher interest rates, the cost of borrowing money, put pressure on hospitals’ cash reserves. Not until March 2023 did hospitals have an overall positive operating margin of 0.1 percent.

Hospitals continue to show financial performance improve recording operating margins of 0.15 and 0.2 percent in April and May 2023, respectively. While this is good news, we must also realize that these operating margins are well below the norms for this industry. Clearly, we have a way to go to recover from 2022.

The pandemic changed many things. Hospitals went from being at surge capacity for months and months during the pandemic to now trying to encourage patients to come back for their routine care. According to Kaufman Hall, “Discharges, emergency department visits and operating room minutes all climbed, although very modestly on a year-to-date basis.” Physicians and market innovators have provided treatment alternatives for patients who were hesitant to visit their local hospitals. Now, these convenient treatment alternatives have provided competition to hospitals providing similar services.

In fact, hospitals are, in some cases, providing significant competition to their own inpatient services. Hospital outpatient revenue is growing significantly faster than inpatient revenue. Hospitals are participating in some of the benefits of healthcare innovation and have developed outpatient programs that can safely and effectively provide more healthcare services in a lower cost setting.

Looking at some simple comparisons, Operating Margins year-over-year from May 2023 compared to May 2022 are 33 percent higher. EBIDA, a measure of profitability, for that same
comparison has improved by 27 percent.

Another positive is that labor costs seem to be in better control. Labor expense per adjusted discharge is down 11 percent when comparing Y-T-D 2022 to 2023.

Hospitals are resilient. Even hospital leaders realize that if they are to remain resilient, they must change to remain competitive with the ever growing medical provider market. Hospitals will also attempt to find alternative solutions to the continuing challenges presented by supply shortages and ever increasing drug prices.

Yes, 2022 was not a good year for hospitals, but, like the Phoenix, hospitals are reinventing themselves to be part of the new healthcare paradigm.



Healthcare providers are working on solutions that will allow them to maintain or improve healthcare quality while at the same time trying to reduce or keep costs constant. Can it be done? And, is AI one of the answers?

We have all been reading articles over the last few years about how AI will change the face of healthcare. Articles that have alarmed healthcare employees that their jobs are going away other articles expressing the thought that AI will be just one more tool in the tool chest and that human employees will assigned other jobs focused on more serious, unique problems.

As AI continues to develop, have those earlier suggested uses changed? Have they grown? Have the potential impacts changed?

As I think about articles that I have read about the coming of AI, I can remember that using “big data” will allow AI to be used to predict disease outbreaks. Using one of AI’s strengths, that being data analysis, to plow through data and to draw conclusions from it. That is still a strength.

I have read about using AI to analyze medical images, such as MRI, CT scans, and X-rays, for early disease detection. AI can also help to diagnose conditions from the patterns in a patient’s medical history and health records. In addition, we have heard about the 360-degree body scanner that will be driven by AI, looking for skin anomalies.

And, we have also heard about AI being used for robotic surgery, giving it more precision, and for telehealth where chatbots can provide medical consultation, triage patients, monitor patient’s health, and provide reminders about medications.

So, what are some of the newer frontiers where we are hearing that AI might be helpful?

One is precision medicine where AI can help doctors understand patient’s genetics, lifestyle, and environment to tailor treatments at an individual level. This approach has the potential to improve treatment outcomes (quality).

I hadn’t even considered that AI could help develop treatment plans by analyzing a patient’s unique symptoms, medical history, and then consult and compare them to the latest medical research.

In an updated “Operation Warp Speed” scenario, AI can be tasked to accelerate the discovery and testing of new drugs. AI can analyze large databases of existing medicines and diseases to identify potential new applications or to create entirely new medicines. AI has the power to bring all that data together and identify relationships and probabilities.

I should have probably mentioned this above, because it tends to cause the most human concern, AI can streamline administrative tasks such as scheduling appointments, billing, and patient pre-screening, thereby freeing up time for healthcare professionals to focus on patient care.

AI can also be used to train our physicians and other healthcare providers of tomorrow by simulating complex surgical/medical procedures or rare medical cases. And, given our current mental health crisis, AI chatbots and apps can provide basic mental health support, direct users to appropriate resources, or provide therapeutic interventions such as cognitive behavioral therapy (CBT).

All of these potential benefits do not come without cost. With access to all those big databases and with the ability to analyze them and to draw conclusions, privacy concerns, the need for explanation, potential biases in AI algorithms, and ensuring that human oversight and empathy remain a central part of patient care are key.

We are seeing the next generation of healthcare developing before our very eyes. The benefits are immense and the guardrails are a must!

By: Jaime Caldwell, President of SFHHA

 



In today’s Modern Healthcare, Caroline Hudson wrote that, “Healthcare research firm Chilmark released a report earlier this month projecting hospital-at-home to grow into a $300 billion industry by 2028, with much of that growth propelled by third-party companies offering turnkey services.”

Her article caused me to remember something that Wael Barsoum, M.D., and then CEO of Cleveland Clinic Florida said many years ago at the groundbreaking ceremony for what was then their new patient tower. When he talked about the configuration of the new tower, he shared that Cleveland Clinic saw the time of the one-day admission going away, wow was he right! With the speed of light, innovators are figuring out how to align with hospitals, or not, to manage this patient cohort at home.

Hospital-at-home, an innovative approach to healthcare delivery, holds great promise and has the potential to revolutionize the traditional hospital system. By allowing patients to receive hospital-level care in the comfort of their own homes, this concept aims to improve patient outcomes, enhance patient satisfaction, and reduce healthcare costs.

One of the key factors contributing to the potential success of hospital-at-home is the growing body of evidence supporting its effectiveness. Numerous studies have shown that certain conditions and treatments can be managed just as effectively at home as in a traditional hospital setting. Patients receiving hospital-at-home care have reported higher levels of satisfaction, lower rates of hospital-acquired infections, and improved recovery times compared to those treated in hospitals.

Another significant advantage of hospital-at-home is the potential to alleviate the burden on healthcare systems. With an aging population and increasing demand for healthcare services, hospitals often face overcrowding and resource constraints. Hospital-at-home programs can help alleviate this strain by freeing up hospital beds for patients who truly require inpatient care. By shifting appropriate patients to home-based settings, hospital-at-home programs can help reduce hospital readmissions and emergency room visits, thus leading to more efficient use of healthcare resources.

Furthermore, advancements in technology and telemedicine have significantly enhanced the feasibility and safety of hospital-at-home programs. Remote monitoring devices, teleconsultations, and wearable sensors enable healthcare providers to closely monitor patients’ vital signs, administer medications, and provide timely interventions when necessary. These technologies not only facilitate real-time communication between patients and healthcare professionals but also enable early detection of complications, reducing the risks associated with home-based care.

However, the success of hospital-at-home will depend on several critical factors. Adequate training and education for healthcare professionals involved in these programs will be crucial to ensure the provision of high-quality care (a recent topic at our Healthcare Summit). Robust care coordination and communication systems must be established to ensure seamless collaboration among healthcare teams, patients, and caregivers. Additionally, clear guidelines and criteria for patient selection, as well as effective risk stratification, are vital to identify patients who are suitable for hospital-at-home care.

While hospital-at-home shows great promise, it is important to acknowledge that not all medical conditions or treatments are suitable for home-based care. Certain complex procedures and critical care interventions may still require the resources and infrastructure of a traditional hospital setting. Striking the right balance between appropriate patient selection and maintaining the quality and safety of care will be crucial to the success and widespread adoption of hospital-at-home programs.

We have read articles over many years now that have said that baby boomers would demand more services be delivered in their home as they age. This is only the beginning.