High-Performing Health Systems Prove Their Value in Responding to COVID-19

Medical group and health system members of AMGA deliver care to hundreds of millions of Americans. They provide routine health care, preventive screenings, as well as urgent and emergency care in both the outpatient and inpatient settings. They are organized in a specific manner to deliver care that is coordinated, high quality, and efficient. AMGA has defined the attributes of this type of care delivery model—a high-performing health system (HPHS). It is precisely these HPHS features that have positioned our members to quickly adapt to the challenge of COVID-19, serving their patients and communities in this evolving environment. Here are some examples of how these HPHS attributes have applied to the COVID-19 response:

Care Coordination: AMGA members have built a care model where physicians, nurses, and other health professionals work together as a team. When COVID-19 hit, the advantages of these cross-functional teams became evident. Many members, such as Sutter Health in California, have done the following: Deployed nurses to triage patients before they enter the offices to prevent COVID-19 patient from infecting others; assigned other team members to staff hotlines to answer the huge increase of incoming phone calls; and recruited physicians and advance care practitioners to inpatient duties to handle the surge of COVID-19 admissions. 

Use of Information Technology: AMGA members have been at the forefront of implementing information technology, including mobile capabilities and a unified electronic health record (EHR). In the past month, telehealth visits have exploded in these groups, increasing in some practices, such as Atlantic Medical Group in New Jersey, from 50 per month to over a 3,000 a day. Enabling all their physicians with telehealth capability has been a monumental task, yet the systems were able to rapidly deploy the technology because of their cumulative IT investments. In addition, because AMGA members had robust EHR adoption, patient care has moved seamlessly into the virtual world. 

Quality Improvement: AMGA members have a systemic approach to improving care, and these lessons have been applied to the COVID-19 situation. For example, at Crystal Run Healthcare in New York drive-through testing and screening tents were created in parking lots almost overnight, and through rapid-cycle improvement methodology, the group has been able to adapt and scale this service. Meanwhile, treatment algorithms have been embedded into the EHRs and are constantly updated, so every caregiver is following the most up-to-date guidelines.

Organized System of Care: Medical groups work in many settings, coordinating care in outpatient offices, ambulatory surgery centers, skilled nursing facilities, and other sites of care. As organized systems, they could swiftly consolidate practice sites to treat all patients with respiratory symptoms in specific centers when COVID-19 struck in their communities. Also, non-hospital beds are being repurposed to handle the surge of COVID-19 patients requiring hospitalization. The leadership structure of AMGA member groups, a dyad partnership of a physician and an administrator, is perfectly designed to comprehensively address both the clinical and operational aspects of the pandemic. 

Accountability: AMGA members have long held themselves accountable to their patients and communities. When COVID-19 struck, many members, including Ochsner Health System in Louisiana, Olmsted Medical Center in Minnesota, and Vancouver Clinic in Washington state, to name a few, immediately did the right thing by cancelling elective surgeries and procedures, preserving personal protective equipment, and postponing non-urgent office visits. These steps were taken to ensure better overall patient care and capacity for a COVID-19 inpatient surge, even though they have resulted in large financial losses for the practices. 

High-performing health systems have demonstrated remarkable resiliency and adaptability in the COVID-19 pandemic that is little over two months old in this country. This is not by accident, as these medical groups and health systems have spent years developing the structures and processes that deliver the best care.