CEO: Hackensack Meridian makes strides in health care equity

The gap in health care availability and outcomes between minorities and other patients was a concern before the COVID-19 pandemic. But the disproportionate toll the virus exacted from vulnerable communities cast a harsh spotlight on the problem. The system had to respond, especially in New Jersey where the outbreak was particularly frightening for so many people. To hear Bob Garrett tell it, the system is doing just that.

In a wide-ranging interview with NJBIZ, the CEO of Hackensack Meridian Health described the efforts he and his colleagues have made and indicated that the results have been real and dramatic. Garrett had recently returned from the World Economic Forum in Davos, Switzerland, where much of the discussion on health care focused on the issues of mental health, equity and climate change. “Health care topics have become more mainstream at the World Economic Forum,” said Garrett, who has attended four such gatherings. “At the very beginning, it wasn’t as prevalent.”

But this year, attendees were given tasks to work on related to equity issues. “We meet, by Zoom, all during the year, the health care community does from the World Economic Forum. … We did sign a Zero Health Gaps Pledge. That requires that we continue to focus on health equity as a top priority and that we do whatever we can within our power to close the disparities that exist today, whether it’s life expectancy or other health care outcomes.”

Garrett also wrote an article for the WEF describing how technology can help in meeting those goals. “New technologies make it possible to recognize and address social needs as part of routine health care,” he wrote. “These digital platforms can identify people who would have previously fallen through the cracks. Food and housing insecurity, transportation issues, mental health concerns, addiction and caregiver stress can be more easily recognized and referred to community organizations aimed at addressing these issues. The goal is to eliminate disparities in health care outcomes based on race, ethnicity and socioeconomic factors. And, by focusing more on prevention, we can further enhance health equity and build stronger communities.” The piece is available on the WEF web site at weforum.org.

Hackensack Meridian Health’s efforts include operating a digital platform called Unite Us that can provide the kind of screening Garrett described in the article for every individual who comes into contact with the system. Nearly 600,000 people have been screened since the platform’s inception 18 months ago, Garrett said, and HMH has made about 1.7 million referrals to a variety of agencies, municipalities or other health care organizations. “That focus alone really helps to close the gaps in health care outcomes,” he told NJBIZ.

The system also focuses on maternal and child health, and that work recently earned a Gold Seal of Approval for Advanced Certification in Perinatal Care by demonstrating exceptional standards and outcomes in the care of infants and mothers. “We have some great data showing that our work is actually succeeding and we were happy that the Joint Commission recognized that work,” Garrett said.

He cited c-sections, which have fallen by 40% at HMH facilities. Last year, HMH recorded zero maternal deaths across the network. And Garrett added that some forthcoming data will show that the system experiences one of the lowest rates of complications in the country. “This data is actually showing that we completely closed the gaps in outcomes between races, meaning people of color and the white population.” The report will be available within the next several weeks. “Once that’s out, that’s going to be groundbreaking research that shows our efforts focusing on health equity, on closing these gaps, are really starting to pay dividends.

In addition, the initial, significant gap in COVID-19 vaccination rates between people of color and the white population completely closed in the later stages of the pandemic. “We made a lot of efforts to work with community leaders, with civic and religious leaders in some of the underserved communities that we serve and it made a difference.”

On the education and research front, Garrett pointed out that BioNJ recently honored Dr. David Perlin, chief scientific officer and executive vice president of the Hackensack Meridian Center for Discovery and Innovation, with the organization’s 2023 Dr. Sol J. Barer Award for Vision, Innovation and Leadership. And he said the Hackensack Meridian Medical School of Medicine is expected to receive its final accreditation in the near future. “We expect by the end of this month, to hopefully hear the great news that this medical school … will be fully accredited.”

Looking ahead

Among other priorities for the remainder of 2023, Garrett cited behavioral health and access to care. “The statistics haven’t changed,” he noted. “One in four Americans don’t have a primary care doctor. So, we need to be out there and we need to be putting our physicians’ offices in locations where there are access issues. We’re also adding a significant number of ambulatory care sites.” He said new ambulatory care sites are coming to Clifton and Clark and sites providing a variety of services, including outpatient cancer care, will be opened in Paramus Totowa.

“As more and more care continues to gravitate outside the hospital, you’ll see more of these ambulatory care settings. And we’re also expanding our services in the home.” The system established its Hospital at Home program in 2022 at JFK University Medical Center; it has since grown to include Jersey Shore Medical Center and Hackensack University Medical Center. In addition, HMH teamed up with a national hospital at home company to eventually launch a statewide program. With the development of new technologies, “we can really provide so much more in the home than we were able to do even a couple of years ago.”

Hackensack Meridian is also dealing with many of the same issues other companies are facing in the wake of the pandemic. Perhaps chief among those challenges is hiring and retaining talented staff members, especially nurses.

“It’s been a rough three years for health care in general throughout the country and in New Jersey … we’re still seeing a significant shortage of RNs, for example,” Garrett said, noting studies showing that 1 out of 5 health care workers have left the field since the pandemic began, a number he called “staggering.”

“But even more troublesome … I saw a national statistic that 1 out of 3 registered nurses, because of burnout, are seriously thinking about leaving the profession in the next 12 to 18 months.” As a result, Garrett said HMH has attempted to reduce stress and burnout among its workforce. He noted the system’s virtual nursing program, launched at Ocean University Medical Center in Brick. The initiative allows nurses, through video technology, to help bedside nurses with tasks that keep them away from the patient, such as charting admissions and discharges, medication reconciliation and other functions that can be performed remotely.

“The surveys we’ve seen [show that] the number one cause of burnout, particularly with nurses, is that they are not able to spend time at the bedside and have that direct patient contact liked they hoped when they went to nursing school and why they went into the profession. And the same phenomenon exists with physicians and we have a chief wellness officer … who has put it many programs to help with physician burnout.” The goal is to free physicians up so they can spend more time with patients.

Health care providers in general are also facing significant financial challenges stemming from the pandemic, which sent wave after wave of patients into hospitals but curtailed most of the revenue-producing procedures the facilities rely upon for financial health. Garrett noted that the Biden administration has indicated it will end the COVID-19 public health emergency in May. That may be good news for many pandemic-weary Americans, but the move will also mean an end to some funding sources that hospitals were depending upon. “So the staffing shortages … and some of the burnout issues that require hospitals and health care systems to hire agency-employed nurses and others at higher costs will just become a more acute situation.”

All of which underscores the importance of a fundraising effort Hackensack Meridian Health launched last year, led by former New York Giants quarterback Eli Manning and Jersey Mike’s Subs founder Peter Cancro. And Garrett said the work is going well. “Their contacts, their connections are great and I have to say each of them is working really, really hard. … They believe in our mission, they believe in our programs.”