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One Year Later: Atlantic Health System CEO Shares COVID Learnings, Innovations

Analysis  |  By Melanie Blackman  
   April 15, 2021

Atlantic Health System CEO Brian Gragnolati shares how the New Jersey-based health system took its learnings from the pandemic and produced innovations, as well as the strategies that the organization hopes to implement in the future.

Since the start of the COVID-19 pandemic, New Jersey has had over 845,000 coronavirus cases and over 22,000 confirmed deaths, according to the State of New Jersey Department of Health.

As of the past week, the state still had over 26,000 active cases, according to the Centers for Disease Control and Prevention.

The Garden State has been no stranger to COVID case spikes, experiencing multiple hotspots throughout the pandemic; including during the early months of 2020 and again in March of this year.

During these surges, Atlantic Health System, headquartered in Morristown, New Jersey, saw as many as 900 COVID-19 patients at one time being treated across the health system's seven hospitals.

While the pandemic created mass chaos in hospitals and health systems across the country, it also gave provider organizations like Atlantic Health System the opportunity to learn and innovate to foster positive outcomes.

Brian Gragnolati, CEO of Atlantic Health System, recently spoke with HealthLeaders about some of the health system's learnings from COVID and what innovations came out from the past year.

"There are certainly a lot of dramatic stories around [the pandemic,] but I don't think people talk enough about … the positive learnings we've had," Gragnolati said.

COVID LEARNINGS

COVID care

During the initial confusion of the outbreak, Gragnolati said Atlantic Health System exchanged information with health systems in New Jersey, New York, and other hotspot areas across the country to highlight best practices related to treating the coronavirus.

"That collaboration that occurred filled a vacuum that we had seen in terms of information about the virus," Gragnolati said. "We were able to quickly change patterns of practice based on what others were learning."

This included reducing the use of ventilators for patients infected with COVID-19, a move that impacted the approach the system took to emergency care.

"Our normal instincts that we have about trying to put people on ventilators to help them recover wasn't necessarily the best approach," Gragnolati said.

Throughout the pandemic, the health system has continued to experiment with a variety of medications and trials to assist patients.

Clinical trials, according to Gragnolati, helped establish what worked and what didn't. Currently, Atlantic Health System is researching the number of monoclonal antibodies to use to help patients earlier in the disease process.

Additionally, with the vaccination effort underway, Gragnolati said the most important thing that has changed, clinically, is “getting the long-term care patients vaccinated."

Although there is currently a rise of COVID-19 cases in New York and New Jersey, hospitalizations are down.

"We're at about 25% of [hospitalizations] compared to where we were during [the surges], yet, we have a pretty big load in the communities," Gragnolati said. "It's because those vaccines, in my opinion, have targeted those high-risk areas and that's helping us out."Related: AHA Convenes Leaders in Fight Against Human Trafficking

Modeling

Gragnolati said that modeling caseloads, which gave the health system's team members a more accurate sense of what their job would look like in the near term, also provided staff with hope when the models didn't forecast the catastrophic numbers that other indicators were showing.

"Our population health strategies, the investments that we made in data systems, and our approach to care management were huge benefits during the pandemic," Gragnolati said. "It enabled us to use the data to look [for hotspots], help make decisions about where we needed to provide additional resources, but most importantly … the modeling gave us a sense of where we might be going."

INNOVATION IN CARE

During the pandemic, Atlantic Health System team members innovated in ways that had not occurred prior to the outbreak due to the breakdown of decision-making barriers, a feat that Gragnolati said he wants to endure as the virus subsides.

This includes the creation of the COVID Recovery Center to care for the adverse medical conditions that COVID long-haulers may face.

According to Gragnolati, the system’s pulmonologists approached the C-suite and suggested establishing the multidisciplinary clinic to create an effective and convenient way to care for patients while freeing up primary care practices.

Currently, the Recovery Center has two locations in New Jersey and consists of a team of cardiologists, pulmonologists, behavior health specialists, neurologists, rehabilitation and physical therapists, and primary care physicians to meet all the COVID patients' potential needs.

Another innovation was utilizing the already established Atlantic Center for Research to research effective ways to treat COVID patients. The Center for Research trialed different drugs for different stages of the virus and helped advance knowledge in the field.

"Early on [during the pandemic] our research team partnered with our clinicians, particularly during the early phases of this," Gragnolati said. "That integration of our research efforts … was incredibly helpful. It led to some of the advances that we're enjoying right now in terms of how we use different types of medications at different parts of this virus process."

Vaccination rollout

Gragnolati said that the health system has recognized the promise of vaccines and decided to "be all in" on the public health effort.

"We were going to do whatever it took to get New Jersey vaccinated as quickly as possible," he said.

The health system currently has 12 vaccination sites, as well as two mobile operations to provide vaccines to vulnerable communities that may not have access to the traditional distribution sites. To date, Atlantic Health System has provided over 3000,000 vaccinations to members of the community, Gragnolati said, including 12,000 [K-12] teachers and school staff.

Currently, the health system is in a situation where it can vaccinate about 10,000 people per day, Gragnolati added, but due to supply constraints, Atlantic Health System is currently vaccinating about 6,000 people per day.

"We would do [more] if we could get a hold of the product," Gragnolati said. "We can't wait until we can get more vaccine, because as soon as we get it, we can get it into people's arms."

Related: Atlantic Health System CEO: 'This is All-Hands-on-Deck'

Atlantic looks forward

While COVID care, vaccination, and research will still be front and center for Atlantic Health System, the organization is also looking forward to innovating in the future as operations normalize.

"We've gotten back to business and our activity levels are close to what they were pre-pandemic, which has been a good thing because it means that people are re-engaging in the healthcare system and getting the care that they need," Gragnolati said.

The health system plans to boost its cardiovascular programs, which Gragnolati praised as one of the best in the country, focusing on revascularization, heart failure, and rhythm disorders.

There are also plans to expand the oncology program and neuro-sciences research.

The real story here, according to Gragnolati, is the health system's population health efforts, which will continue to grow.

“We have taken a lot of our contracts and work with our insurance partners to create risk arrangements," he said. This includes ongoing work with Horizon Blue Cross, which makes up about 25% of the health system's Blue Cross business.

Gragnolati said that data from Atlantic Health System and Horizon's population health effort revealed there has been a 9% reduction in hospitalization rates and a 5% reduction in per capita spending in the first year.

"[Population health] addresses the issues of healthcare costs … it's complementary to what we're doing with the Medicare programs, and we want to extend that to other payers. So that's going to be a big effort moving forward," he said.

Related: Atlantic Health System, CentraState Reach Definitive Agreement

“There are certainly a lot of dramatic stories around [the pandemic,] but I don't think people talk enough about … the positive learnings we've had.”

Melanie Blackman is the strategy editor at HealthLeaders, an HCPro brand.


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