If You Can't Get to the Doctor, the Doctor Will Come to You

A fleet of planes is just one way that Driscoll Children's Hospital makes sure its patients (and their families) get the care they need.

When your patients are sick children, you bring healthcare to them. And that's where true healthcare innovation happens.

Such is the case with Driscoll Children's Hospital. Based in the southern coastal city of Corpus Christi, Texas, the pediatric health system comprises two hospitals and a number of specialty clinics and care sites covering a 25,000-square mile swath of rural southern Texas roughly the size of South Carolina.

Driscoll was launched in 1953 by Clara Driscoll, an author, politician, activist and rancher who spoke five languages, was a confidant of FDR and was credited as the ‘Savior of the Alamo.' She had a soft spot for children, especially those on the opposite end of the economic spectrum, and upon her death in 1945 left her fortune to a fund that would create the hospital.

Mary Dale Peterson, Driscoll's Executive VP and COO, says it's that "Renaissance spirit" that propels the health system today. Among its accomplishments is a 98.5% survival rate across more than 600 pediatric cardiac surgery cases, one of the best in the country. And their length of stay is among the shortest in the country, with transition housing on the hospital campus to help patients and their families move more quickly from the hospital back home.

"You don't always have to be in the largest urban areas to create greatness," she says.

Mary Dale Peterson, Executive VP and COO of Driscoll Children's Hospital. Photo courtesy Driscoll Children's Hospital.

Healthcare innovation comes in many forms, and at Driscoll it begins with the idea that healthcare access is a priority. That's why Driscoll has a fleet of five planes that cover a 33,000-square mile area each day, ferrying specialists to clinics and transporting children to hospitals.

"We have a history of bringing care to the children where they are," Peterson points out.

She says the service dates back to Jim Simpson, a cardiologist who flew his own plane across the state some 50 years ago to screen remote children for congenital heart disease. The planes, purchased through philanthropic donations, help specialists like the only pediatric rheumatologist in all of south Texas meet with children and their parents, saving them hours-long car trips and days away from home.

And it saves money. Peterson – who was president and CEO of the Driscoll Health Plan from 2005-18 before joining the hospital – says the fleet saves Driscoll millions of dollars in Medicaid costs, while also improving time and access to treatment, which in turn improves clinical outcomes.

"We've saved the state a lot of money by flying our doctors to these communities," she says. "Maybe the new innovation is figuring out how we provide equivalent care to our rural communities that we have in our urban communities."

'What We Want to Do Is Really Look Upstream'

That's not the only instance of bringing care to the kids. Driscoll recently launched a pilot project to embed behavioral health specialists in primary care practices as well as local schools.

Peterson says the idea was borne out of a troubling statistic: A 60% increase in ER visits for children over three years, due only in part to the pandemic. In short, children were experiencing mental health crises, and they and their families weren't recognizing the warning signs or seeking help until the only option was emergency care.

With some grants and philanthropic money, health plan funding and an alternative payment program, Peterson sent specialists out into the communities, coordinating with pediatric primary care practices and five elementary schools and a high school.

"When I got to thinking about it, it's like, how do we prevent children from going into crisis?" she says. "We don't have inpatient mental health services in our hospitals, so they end up in overcrowded EDs. What we want to do is really look upstream."

Another example: In 2007, while head of the Driscoll Health Plan, Peterson studied the data on pre-term births and noticed that 20% of all births were ending up in the NICU, while 30% of all births were medically induced. In addition, there was only one maternal-fetal medicine specialist in south Texas. That led to a $10 million investment to establish clinics and build up the telemedicine program, moves that helped bring the pre-term birth rate down to 9% and save millions of dollars in healthcare costs.

"I've worked 30 years as a physician treating these babies with the ravages of prematurity," she says. "I know we can't prevent every preterm baby, but we can do better."

"There's a lot of, you know, sexy technology that's out there in the surgical realm that I love … but I think there's a whole lot of work that we still have to do in the non-sexy areas that have a huge impact on people's lives," she adds. "And that is in coordination of care and behavioral healthcare, and really helping families who are struggling with these issues."

Data and Dollars

As a former health plan president, Peterson says innovation is predicated on two ideals: New ideas are based on data proving their value and can be justified financially. With a patient population in which some 80% rely on Medicaid, that's a challenge.

"Having an integrated health system where we have a health plan, a physician practice group and the hospital all working together helps with that," she says. So the health plan manages the risk, and the health system turns that into opportunity.

That philosophy has helped her to understand when a new idea doesn't work as much as she might want. Peterson says Driscoll embraced telehealth enthusiastically during the pandemic, which was pretty much the only way to access most care. But after the crisis, she crunched the numbers and found that care management had suffered, and well-child visits and immunizations had dropped.

"We'll offer it to everyone," she says of the virtual care platform, "but patients actually do prefer face-to-face visits."

So Driscoll mixes its platforms, offering virtual care alongside in-person care to meet the needs of its patients and their families. Peterson says she's eager to blend the two with new ideas, like remote patient monitoring and AI. And she's excited about research in genetics and precision medicine that is creating new treatments for children.

"In the past you would just have to tell these families their baby's going to die, but now we have something to offer," she says.