In our annual HealthLeaders 20, we profile individuals who are changing healthcare for the better. Some are longtime industry fixtures; others would clearly be considered outsiders. Some are revered; others would not win many popularity contests. They are making a difference in healthcare. This is the story of Bryan Coffey.
This profile was published in the December, 2014 issue of HealthLeaders magazine.
"It doesn't matter how close a hospital is to closing its doors; there's a model that can be followed to keep it alive."
Faced with budget cuts, dwindling patient populations, and difficulty in recruiting clinicians, many rural hospitals are cutting services or closing their doors completely. But Hamilton County Hospital in Syracuse, Kansas, is expanding its services and increasing its patient load by bringing itself into the 21st century.
Some people might not want to live in an area so rural that the nearest Wal-Mart is 50 miles away, but Bryan Coffey, CEO and chief financial officer of Hamilton County Hospital, thinks it's the perfect location to live, work, and raise a family. It's also an ideal place to pursue his two greatest passions—rural healthcare and telemedicine.
Coffey spent the beginning of his healthcare career as a systems strategist. In 2007, he made the transition into leadership and became the CFO of Fredonia Regional Hospital in Kansas. His first experience as a CEO was at Sac-Osage Hospital in Osceola, Missouri. In that role, Coffey realized that hospital CEOs are in a unique position to transform healthcare in the United States.
"Through CEO leadership, I could effect change in healthcare more effectively and efficiently than as a CFO," he realized. His appointment at Sac-Osage was a yearlong contract role he took on for the small rural hospital. It was then he realized he enjoyed the challenge of turning around failing healthcare facilities.
Located on the plains of eastern Kansas, Hamilton County is sparsely populated. For specialty medical services, such as pediatric care, residents are asked to drive for hours to get treatment. Additionally, there are situations such as a stroke, when every minute without the right medical attention can mean the difference between life and death.
Hamilton County Hospital, a 25-staffed-bed critical access facility, was in a "death spiral" when Coffey chose to take on the challenge of both saving the hospital and bringing it into the modern era. "It doesn't matter how close a hospital is to closing its doors; there's a model that can be followed to keep it alive," he says.
When Coffey first arrived in June 2013, it had not employed a physician in years. Turnover was around 70%, and the majority of the work was divided between a nurse practitioner and a physician assistant.
Coffey first chose to focus on outpatient care, then began equipping the hospital with state-of-the-art tools. "Once inside, visitors quickly come to understand we're a high-tech facility," he says. Among the equipment is a specialty MR scanner and a 16-slice CT scanner.
The facility's pride and joy, however, is a robot with a screen mounted at eye level that allows doctors in locations as far away as California, New York, and Massachusetts to see patients remotely. "That robot really makes its rounds," says Coffey. "It's used for neurology, stroke treatment, heart attacks, and the rural health clinic attached to our hospital." This tool makes Hamilton County feel much more connected.
Coffey and his staff have been able to widen the offerings at the hospital, including dermatology, rheumatology, endocrinology, immunology, pulmonology, psychology, and neurology. There are plans to offer first-trimester pregnancy care and an ear, nose, and throat specialist.
Employee turnover rates have gone from 70% annually to 25%. The volume of patient visits has grown by 40%, which has prompted the hiring of new clinicians who have joined the team. Coffey also implemented a 360-degree review process and yearly employee appreciation events. The last appreciation event had 90% employee attendance and featured morale-building prizes like paid time off and gift certificates.
"Here in Syracuse, we're excited about what the future holds. Not only is the hospital not closing, but … we've got a successful model for rural healthcare. We've experienced phenomenal growth and turnaround," Coffey says.
In addition to spreading the word about telemedicine to other organizations by speaking at conferences and publishing a white paper about how rural organizations can afford their own robots, Coffey has been fighting for growing acceptance of telemedicine.
"I've worked with local politicians in both Missouri and Kansas to improve access to telemedicine, but I want to get more involved at the federal level. Telemedicine can be rolled out to the entire country. It will increase access to providers," he says.
Coffey's belief that telemedicine is the future of rural healthcare is unequivocal. "Telemedicine can really be leveraged in rural America. And not just specialists, but primary care, too. We have such a shortage in rural America of primary care. The leading innovation has to be through telemedicine."
Lena J. Weiner is an associate editor at HealthLeaders Media.