(Article is part of Virginia Gay Hospital’s bi-annual publication, “Thrive” Spring/Summer 2017 issue. Online version can be found at https://myvgh.org/thrive/)

Health care has been at the front of the national conversation for years now. Where is all of this leading Virginia Gay Hospital? What is the future of health care in Benton County? We sat down for a conversation with Virginia Gay Hospital Administrator Mike Riege to explore those topics and more.    What follows is a lightly edited version of that conversation.

Mike, is there anything we can learn from the past about where Virginia Gay might be heading in the future?

When I came to Virginia Gay 27 years ago the hospital was just coming off a rough decade where we’d lost a lot of money. I came in as the chief financial officer, so I was very aware of the constraints we were facing, but immediately it was clear that the staff, the community, and our board really wanted Virginia Gay here providing health care for the community. We had everyone rowing in the same direction, and working together means good things are going to happen. Those same feelings are still true today, and as long as we have the support of our patients, our staff and our communities, Virginia Gay will be providing health care to Benton County for a long time to come.

Who were some of the people in the past that made Virginia Gay the success it is today?

By far you would have to put George Garwood as both our most colorful character and, undoubtedly, the one person who had the greatest positive impact on Virginia Gay. George started as a nurse and worked everywhere in the hospital. Back when local doctors took tonsils out, George was often the anesthesiologist and you could find George in the ER or working on the floor helping patients. When it came to understanding Virginia Gay and local health care, no one had a better grasp of things than George did.

When we think about what has made Virginia Gay stronger over the years I would include Dr. Anthony’s vision foreseeing the value of the physician assistant in medical practice. Dr. Anthony trained many physician assistants and several of them are still with Virginia Gay. I think we offer the practicing physician assistant or nurse practitioner the opportunity to be true partners, along with doctors, in providing health care, and that began with Dr. Anthony.

He passed that tradition on to Dr. Meeker who is an associate professor at the University of Iowa and has provided training to probably hundreds of mid-levels, and again, many of the best and most able choose to stay with us after their training.

What projects are underway now that will be improving the health of Virginia Gay’s patients well into the future?

There’s been a lot more going on than people will want to hear about, so I’ll  try limiting myself to a few highlights from those that will be having the most impact.

When you see a provider in the Vinton clinic you will notice that they’re wearing some odd-shaped glasses. Those glasses are part of a service called Augmedix that uses Google glass to communicate with trained scribes located in San Francisco. Those scribes are putting information in the computer to document every part of the patient’s visit. I don’t think we’ve ever had a change that was so immediately successful, let alone gratifying to use. What I mean by gratifying is that our providers went into medicine to treat patients, and with Augmedix they can once again attend to patients rather than spending their time and attention documenting the visit for the insurance companies, Medicare and Medicaid.

We aren’t completely done with our evaluation, but if Augmedix continues to prove itself, I would recommend its adoption in all of our clinics.

The new clinic in Vinton is another big step. In about three months the first phase will be complete and we’ll be ready to move into that part of the building. We’ll have room for nine providers in the clinic, there will be improved patient privacy from check-in to check-out, the waiting area will be much more comfortable, and we will have room to grow in the future on the second floor.

In addition to more room and more providers, we also want to establish behavioral health as part of our offering. Providing access to mental health care is probably the single-most important thing we can do to improve the overall health of our patients.

Improving overall health of our patients fits into the last big project, and that has been our work to improve quality and reduce costs. Two years ago we were in an Accountable Care Organization (ACO), a group of hospitals from across the nation that saved Medicare $2 million. This past year we joined an Iowa-specific ACO of six other rural hospitals and together we saved Medicare $5 million. Medicare gets half the savings we create and the rest goes into a fund to help continue the improvements. I’m happy to say that Virginia Gay is one of the lowest-cost and highest-quality hospitals in the group.

I’ll give a couple of specific examples of where we stand. On average, a stay at Virginia Gay Hospital is 35% less than any other hospital in the state. And when it comes to a routine surgery like having a gallbladder removed, our costs are about 50% less.

We’ve done all this while adopting the EPIC electronic health record with the assistance of the University of Iowa, which was a major project on its own. If you haven’t checked out “My Chart,” you should. There will be many positive changes coming about through EPIC in the years to come.

Last question.  Is there a department or service at Virginia Gay that you take special pride in?

I’m proud of our entire staff, and I think every department exemplifies quality care and is continually improving, from housekeeping to dietary to surgery. But the one that comes first to mind might surprise you.
My 100 year-old mother is a resident in our nursing and rehab facility, and she’s there because I think our staff is absolutely outstanding. That isn’t just my opinion. It’s a 5-Star nursing home, and that’s five stars across the board. That puts us at a higher level than almost every home within 50 miles. That isn’t just my opinion; you can check it out for yourself at Medicare.gov.

I have a pretty hectic schedule but if I need to get grounded…to remember why we’re doing this work, all I need is to take a short retreat during the day to watch the staff in long-term care work with their patients. Watching the care and attention the people of Virginia Gay give our elderly patients truly inspires me.