New normal: Gragnolati describes future of hospitals (and health care)

Maintaining new partnerships, drive for innovation will help country coexist with virus that’s not going away

Brian Gragnolati. (File photo)

Atlantic Health CEO Brian Gragnolati recently discussed how the system is treating a high number of long-haul COVID-19 patients — or those whose symptoms stay with them for weeks and months after their treatment.

It’s an example of how, even with the vaccine, COVID-19 is not simply going to go away. It will forever impact the way health care companies provide care.

So, we asked Gragnolati, a former chair of the American Hospital Association, how health care delivery will change moving forward. He gave us four examples:

Coexisting: “COVID is endemic in the community, and, therefore, it’s going to be for the foreseeable future. The real question is going to be, how many people end up getting vaccinated? And what levels of immunity exist in the community so that it becomes something that is easily coexisted with — not unlike other viruses that that we have. We’re going to have to coexist with it.

“And I think it remains an open question about whether or not there’s going to be additional vaccinations required, past the first vaccine that you take. So, I think we’re still learning a lot about this virus. But there’s no doubt we’re going to be in the business of both taking care of COVID patients and providing vaccinations for the foreseeable future.”

Improved population health: “What we’ve learned through this pandemic is that the efforts that have been undertaken over the last decade under the banner of population health — how do we improve access to care? — have been critically important.

“It’s something that we’ve been aggressively pursuing at Atlantic. And, during the pandemic, the investments that we made paid off in enormous ways. Having people on a common electronic health record was huge. Telehealth and remote monitoring were critically important.

“We have a program called Advanced Care at Home. At the peak of pandemic, when we had 900 patients a day in our hospital, we also had another couple hundred at home that we were caring for. That was something that we knew we had the ability to do. But the pandemic gave us the impetus to do that. And now that is a program for us.

“Staying with these programs is predicated on the government continuing to view it as important and allowing the payment policy to adapt so that physicians and facilities can get paid for these kinds of care. But the second thing is that the insurance companies have to stand up and continue to support these programs. I do think that those things will happen.”

Innovation: “This is both at the bedside and with simple things, like the supply chain, and more complex things, like setting up vaccines in quick order. That level of innovation that was driven by the pandemic needs to stay in place. I know one of the struggles that we have in hospitals and health systems is the quest for ‘perfect’ all the time. And that gets in our way sometimes. We learned how to do both the perfect and quick during the pandemic and I’m hoping that we can continue to emphasize that and keep that spirit of innovation.”

Partnerships: “We created a great partnership with the state from the beginning. But we also created partnerships with competitors. Early on, we worked with RWJBarnabas Health and Hackensack Meridian Health in a very deliberate way for supplies and sharing ideas about how to best care for these patients. And then, that partnership has broadened very quickly and became part of what the New Jersey Hospital Association is doing.

“But partnerships, like the one we have with CentraState on a one-to-one basis, really helped, too. Because we were able to share what was going on in our markets. And, if one organization or the other needed some help in a particular area, whether that was through PPE or just what we were learning, we were able to do that.

“And then, there were the partnerships with suppliers, which change. Being able to do things that made more sense, different from our traditional relationship, helped tremendously.”