Health Care Sustainability: That is why the UVM Health Network exists, and it is what we do

Rural health care is in peril: It simply is not sustainable in its current form due to financial, demographic and workforce pressures. So it’s a good time for the health care sustainability discussions happening across our region. We at the UVM Health Network have some important lessons to share – examples of how achieving sustainability leads to better health care for the future and for right now. But we need local support to keep this critical work going.

Building a sustainable health care system has been my focus for more than a decade. In many parts of this country, people living in rural areas do not have adequate access to important services, from primary care to the complex and specialized services provided at an academic medical center. Since 2010, 138 rural hospitals have closed nationwide, and today, many more are on the brink of financial collapse. My colleagues and I launched the UVM Health Network in 2012 to avoid this outcome: We are an integrated academic health system that serves more than 1 million people in Vermont and northern New York.

Here is one example of what sustainability looks like for our patients: In Ticonderoga, New York, the former Moses Ludington Hospital was a failing, 15-bed critical access hospital with an average of three patients in-house daily. Today, it has been transformed into a medical village offering a variety of complementary health care services that respond to the community’s needs in one convenient location. The medical village, on our Ticonderoga campus, is a part of the UVM Health Network’s Elizabethtown Community Hospital, a critical access hospital about 30 miles away. In addition to primary, specialty and 24-hour emergency care, patients are able to receive laboratory tests, medical imaging and outpatient physical, occupational and speech therapy in Ticonderoga. This saves some patients from having to drive an hour or more for care they need, and it helps patients avoid the sometimes-severe consequences of delaying care.

Sustainability is not a one-size-fits-all proposition: It must be tailored to a community and its health care needs, now and into the future. Alice Hyde Medical Center is deeply rooted in Malone, but it’s worth noting that the high-quality health care provided to Malone residents is the result of a regional partnership that goes back decades. Alice Hyde and UVM Medical Center in Burlington, Vermont, first established a clinical affiliation in 1997. The connection to Plattsburgh is strong, as well: Cardiologists (such as Eric Gauthier, MD; Pierre Znojkiewicz, MD; and Joel Wolkowicz, MD) and oncologists from Champlain Valley Physicians Hospital have been staples in Malone for years. Other regional physicians have provided important health care services in Malone as needed, and will continue to do so. With a national physician shortage, preserving access to specialty care requires providers practicing in multiple sites rotating through our communities.

This is why it’s so important to be part of a tightly woven system of care. The UVM Health Network is working to preserve and improve access to critical health care services across our region. It’s all about sharing. The organizations that are part of our health system – including Alice Hyde – share expertise and resources, which helps us provide the right care, when and where our patients need it, while quickly responding to challenges and crises like COVID-19.

We share support systems that allow our talented workforce to do what they do best. The Epic electronic health record system, which is now in place at all of our Network’s hospitals including Alice Hyde, is a good example. We also share a commitment to improving the health of our communities; to creating a more equitable and inclusive environment for our patients and our people; and to transforming the way health care is delivered and paid for so we can focus on wellness as much as illness while controlling costs. Emphasizing prevention and primary care is one way we’re working to keep our communities as healthy as possible.

Health care sustainability is a challenge, but it’s not a mystery. There are some essential drivers of sustainability, no matter where this work is undertaken. We need progressive health care leadership invested in working together for change. We need engaged and supportive communities. We need financial support, especially from governmental partners. We also need caring and committed providers and staff to make sustainability real. The physicians mentioned earlier are prime examples, as they offer patients potentially life-saving care closer to home.

Health care will continue to evolve – in Malone, in our region and across the nation. This sometimes requires painful decisions, like the recent closure of Alice Hyde’s birthing unit. Taking a regional approach is key to the sustainability of high quality rural health care. By working together and in the best interest of our communities, we can help ensure that all of our patients will get the care they need for many years to come.

  • John Brumsted, MD
    CEO, The University of Vermont Health Network