Next steps: Garrett explains how HMH is doing now — and its plans for post-pandemic health care world

By Tom Bergeron
Hackensack | May 6, 2020 at 12:25 pm
Q&A

Hackensack Meridian Health had the first recorded COVID-19 case in the state — and it has treated more cases than any other system. In fact, on Tuesday, it released a patient from its system for the 5,000th time since the pandemic started in mid-March.

The system, which includes 14 hospitals as well as dozens of other health care facilities, was treating as many as 3,000 patients a day in mid-April. It’s now treating approximately 1,250. It’s a nice drop, for sure. But CEO Bob Garrett said it’s no reason for anyone to feel the pandemic is over.

ROI-NJ talked with Garrett to get his take on all things COVID-19 and health care in the state.

Here’s a look at the interview, which has been condensed for clarity:

ROI-NJ: What is the state of the COVID-19 pandemic at HMH right now?

Bob Garrett: We’re seeing the trends continuing to decrease. Hospitalizations continue to go down. There are individual lifts from day to day, but the macro trend is continuing to go down. Having said that, though, are we numb to this? No. We’re not, because we’re still seeing a significant number of patients in our hospitals, in ICU on ventilators and, unfortunately, seeing patients dying from COVID-19.

I would say we’re still very focused on the response, which has been an all-hands effort from the beginning, whether that be increasing capacity by tripling our ICU, whether it means ramping up our testing, which we have significantly done, whether it means securing a steady supply chain for PPE and ventilators and other types of supplies and equipment, which we did.

ROI: This begs the question: Where does the system go from here?

BG: We’ve formed a steering committee internally to look at how we can fully recover from this pandemic — what lessons did we learn and what’s the new norm? We’re looking at everything, the entire way that care is being delivered. We’re looking at our structure — how does that work in a post-pandemic world? And we’re also looking at, how do we prepare for the next wave, which Dr. (Anthony) Fauci and others have predicted is going to come this fall or winter.

ROI: Do you see any immediate changes that you’ve made sticking in a post-pandemic world?

BG: There are plenty. One good example is telemedicine. How do we make sure that that our medical practices are structured going forward so that these telemedicine visits can continue? Because I think a lot of people will be receiving primary care and interactions with physicians and other providers through telemedicine.

More than 50% of our medical visits right now are being done through telemedicine. And, prior to the pandemic, that the number was more like 5%. That’s just one example that we’re looking at with the steering committee.

ROI: Moving forward, some are talking about allowing hospitals to do more procedures — including elective surgeries, which currently are not allowed. Where do you stand on that?

BG: It’s not just ‘elective’ procedures, it’s all procedures. Under Executive Order 109, all elective procedures — those that are non-urgent, non-emergent — are not permitted. But the order was never intended to stop people who do have medically necessary, time-sensitive conditions from coming in to get care.

So, we are gearing up to be able to expand our capacity to do that. We’ve designated totally non-COVID-19 units throughout our hospitals. And we’ve thoroughly cleaned, disinfected and fogged the entire hospital.

We’re concerned from a public health perspective that there are a lot of a lot of people out there that have not sought to get the appropriate care. So, I think there’s pent-up demand for that and we want to assure everybody in the public that hospitals are safe and that we’ve taken these additional steps to be ready to accommodate these types of patients.

ROI: How big of any issue is this. Everyone is talking COVID-19, no one is talking cardiovascular disease. What are we missing?

BG: Heart attacks and heart conditions didn’t go away. COVID-19 didn’t stop people from having strokes or having issues with diabetes continue to progress. All of that didn’t stop just because COVID-19 happened.

The fact that people are putting off going to the doctor, getting treated, getting diagnostics is going to make it even more challenging down the road for the health care industry. There’s no question about that. This certainly is on the docket as next steps.

ROI: Of course, being able to add elective surgeries would help your bottom line, too. You would need Gov. Phil Murphy to rescind that order, though. Are you pushing for that? Do you think it could come soon?

BG: We’re trying to do our best to advise the commissioner and the governor when it is safe to reopen those types of procedures to be done at hospitals and ambulatory surgery centers under certain conditions. It’s hard for me to put a date on it. But my guess would be that the commissioner and the governor will probably be considering those things over the next week or two.

ROI: This goes to the bigger issue of the times: reopening the economy. From your standpoint, do you think the state is ready?

BG: I think we have to be very cautious. The overall trends are more positive, but we have to be careful as we kind of put our foot on the gas in terms of reopening. I understand the need to reopen, because we need to get our economy back, but we have to do it very safely. No matter how safely you do it, there are going to be more cases. That’s inevitable. We just have to make sure that we can manage those cases and that it’s just a small number.

You can’t say that there’s going to be zero cases. Countries around the world with far fewer cases are still seeing cases. I think we’re going to have to live in that dual world for some time. It’s going to be a question of getting the timing right and doing it safely.

ROI: The governor talks about the need to ensure the population is healthy before we make the economy healthy. But what about making the health care industry healthy from an economic perspective?

BG: In my view, you can’t restart the economy in New Jersey unless the health care system is strong. Not just from an infrastructure perspective, but rebuilding it financially, too. To be able to go forward and be able to keep people safe and keep the economy open, our health care system can’t be devastated or overwhelmed. We need to make sure that it’s sound financially and that appropriate resources are going toward it. That’s one big effort and a strategy that has to happen.

Remember, health care is a huge economic engine. Some say it’s one-sixth of the economy. How do you bring the economy back without health care being strong? It’s just really unbelievable that, in the middle of a national public health crisis, some hospitals and health systems — not necessarily in New Jersey, but in other states — were so devastated financially that they’ve had to furlough or lay off employees. What’s wrong with that picture? That’s really incredible and not a good sign at all. We can’t have that happen here.

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