WellSpan CEO talks about prepping for COVID-19

In January, Dr. Roxanna Gapstur, president and CEO of WellSpan Health, told one of the York-based hospital system’s leaders that she was keeping an eye on a virus that was spreading through China.

By February, COVID-19 had seen significant growth into other countries and Gapstur began speaking with her team about how prepared WellSpan was for a pandemic.

Gapstur spoke to the Central Penn Business Journal last week about how the hospital system handled the pandemic since those initial conversations, and the effect the COVID-19 pandemic has left on WellSpan and its hospitals.

A Minnesota native, Gapstur joined WellSpan as president and CEO on Jan. 2, 2019, after holding a number of leadership positions for more than a decade at Minnesota-based Park Nicollet Methodist Hospital and its parent company, HealthPartners.

“As a nurse and health care executive for as long as I have been, every time there are emerging infections around the world, it perks my ears up a bit,” she said.

WellSpan launched its first incident command center in February. They focused on the system’s supply chain and determining which resources its hospitals would need should it be inundated with COVID-positive patients.

The system was also an early adopter of outdoor testing sites, which it set up outside hospitals and ambulatory facilities. Twelve sites were launched, allowing the system to separate possible COVID-19 positive patients from other patients at WellSpan’s facilities.

So far, WellSpan has tested more than 20,000 people, with an average 10% to 11% of tests coming back positive. Gapstur said that the system is now working on expanding its tests to more individuals and not just people with symptoms.

“The U.S. supply chain has definitely been impacted by the pandemic so the access to testing has been for people with symptoms,” she said. “It’s something we are working on as well as other health systems so we can test more Americans and use that to help people quarantine more appropriately.”

The inevitable spread of COVID-19 into the state struck the eastern end of the state and moved westward, meaning WellSpan’s Ephrata Community Hospital and Lebanon’s Good Samaritan Hospital saw the most positive cases, followed by hospitals like WellSpan Chambersburg Hospital.

WellSpan’s size proved advantageous during the spread of the virus, since it could provide additional staff and personal protective equipment to the busiest hospitals and send them back to other hospitals as needed, Gapstur said.

While its size allowed it to share personal protective equipment in a way that smaller systems couldn’t, Gapstur said that WellSpan has still been affected by shortages in equipment.

The MacGyver approach

To address the issue, WellSpan leveraged York County’s large manufacturing industry and worked with companies to create its own supply chain of PPE in anticipation of other surges.

“We formed a MacGyver team,” she said. “If there was a piece of personal protective equipment that we felt we needed more of, they started understanding how we would make it and what we would need. Some people on the team were engineers and they had contacts.”

Some companies WellSpan is currently working with include Letterkenny Army Depot in Chambersburg, which is helping the system manufacture gowns and JEMIC Shielding in Harrisburg, making face masks.

Prior to the pandemic, WellSpan was in the process of putting into effect “WellSpan 2025” a strategic plan that Gapstur said tasked leadership with leading the region in “value-based” care and providing more ways for patients to access care.

Gapstur said the pandemic actually quickened the pace of WellSpan’s plan and put some parts of the strategy into motion than originally planned. Part of the strategic plan was to oversee a growth in telemedicine, which grew organically after the pandemic caused a state-wide quarantine and at-risk patients were asked to stay home from health care facilities in case of exposure to COVID-19.

“Where we might have done 1,900 video visits in a year before this, we are doing 1,900 a day,” said Gapstur. “It’s been just an explosion of virtual care which I’m sure our communities have appreciated.”

The Centers for Medicare and Medicaid Services (CMS) is currently offering providers increased reimbursements for telemedicine services for patients with Medicare when telemedicine previously paid back much less than a formal doctor’s visit.

While other third parties have yet to follow in Medicare’s footsteps Gapstur said WellSpan is talking to its payers about how virtual care will be changing moving forward.

“We haven’t got into conversations about what the rates will be, but I do think they are supportive of virtual care continuing and I think having CMS’ support virtual care is the first step of all of us moving forward,” she said.

Since it still receives reimbursements based on a fee-for-service model, WellSpan and its hospitals have taken a financial hit thanks to the drop in patients coming to its hospitals and the state’s pause on elective surgeries in the first two months of the quarantine.

Fewer patients

WellSpan anticipates its patient population to continue to stay well below the average for some time. Like many health care providers faced with the sudden drop in patient population from the pandemic, Gapstur said the system is concerned about when its patients will feel safe to go to the hospital again, but is seeing a gradual return thanks to its hospital’s safety protocols.

“We are all sheltering in place and doing our part to slow the spread and it becomes the norm to shelter, so going out into the world again and experiencing places that people feel that COVID has been at can feel scary,” she said.

Gapstur attributed much of her system’s success to her leadership team at WellSpan. However, WellSpan’s president and CEO has a long history of executive leadership and nursing experience at hospitals. She was a nurse at University of Minnesota during the AIDS pandemic.

While she has seen many similarities in the two pandemics, the main lesson she learned from both was the importance of operating on facts. “We didn’t have enough facts as we needed at the beginning of that (AIDS pandemic) and we’ve been thoughtful and careful during the COVID-19 pandemic to try and use the facts that we have and gather as many facts as we can before making recommendations to our community,” she said.

Watch the full interview below: