← Advancing Health
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- [00:00]
A
Welcome to Advancing Health. In February's leadership dialogue podcast, Dr. Mark Boom, President and CEO of Houston Methodist and the 2026 board chair of the American Hospital association, speaks with a top rural healthcare leader about how creativity and excellence can address the unique challenges facing rural providers.
- [00:23]
B
Well, greetings and thank you everybody, for joining me today. I'm Mark Boom. I'm the president and CEO of Houston Methodist, and I'm excited to be the chair of the American Hospital association this year. As I mentioned during my first leadership dialogue in January, I believe innovation is just a critically important part of ensuring that patient care is absolutely unparalleled. So my plan to hopefully weave innovation as a theme throughout each of these discussions. And so today we're doing exactly that again, but this time through the lens of a rural hospital leader. I know that all of our colleagues, whether they're leaders of big health systems or small independent hospitals, are committed to innovating to deliver the best possible care to the people they serve and also navigating big changes and challenges in our field. And we know that when it comes to challenges, the leaders of our rural hospitals, frankly, have a whole extra degree of complexity. I mean, recruiting staff, the administrative and reimbursement challenges, transportation, just to name a few. And I know I'm anticipating our guests today will share that amidst those challenges, many opportunities for growth in innovation. Just two weeks ago, I attended the AHA's Rural Health Care Leadership Conference, and I was totally energized by the sessions and the discussions that were there on building innovative approaches to transformative care delivery. So today we have as our guest, Marc Bucault. Mark is the president and Chief Executive Officer of Potomac Valley Hospital in Kaiser, West Virginia. He attended the conference as well. I met and chatted with him there because he was the recipient of the AHA's Rural Hospital Excellence in and Innovation Award. That's an award that recognizes rural hospitals that demonstrate responsiveness, creativity, and excellence in developing or sustaining programs that address the unique challenges that face rural and frontier communities. So, Mark, welcome today. I'm glad to have you here.
- [02:15]
C
Well, thank you for having me. I'm honored to be here.
- [02:18]
B
And we'll keep it nice and confusing with 2 marks today, maybe we'll pronounce them slightly differently. Mine's with a C, yours is with a K. But it is great to have a fellow Mark here for our podcast today. So I want to dive right in. First off, I know Potomac Valley Hospital, which you lead, is part of WVU Wet Medicine, which, if I'm not mistaken, you are a 25 bed critical access hospital. So let me start. Tell me a little bit more about the hospital and the community you serve.
- [02:45]
C
Yeah, that's correct. We're a 25 bed critical access hospital. Although you'd be very surprised about the amazing array of services that we provide there. The hospital basically has general surgery, orthopedics, very strong orthopedics program along with multiple specialty services. We opened a hematology oncology center there in our geography to serve the patients that we were blessed to take care of. We have urology, we have along along with that we have colorectal surgery, we have pain management. So there's a pretty vast array of services. We serve a market area of really I think it's a three county area that comes to the hospital, our community, Potomac Valley Hospital, about 50,000 residents, but we serve a much broader area. People come from about an hour away. And really I think one of the things that for me that is a hallmark of our organization is that we have adopted a mission statement that we care for every patient like we would our own family. And so with that, as our North Star, we are able to innovate and develop patient care services for our community, always knowing that we're going to care for them, we're going to include them, we're going to incorporate their needs, most importantly, because everything that we do is for them.
- [04:10]
B
I'd love to hear about your technology journey. We believe, and that's why I'm weaving this in these series, that innovating through technology can really transform innovation. And when you talk about that North Star, which I love of it's all about the patients. That's why we're all in healthcare. And I assume when you're looking at technology as a critical access hospital, it's all about the patient, how you do that. So how do you think about technology solutions, the infrastructure improvements, care management, all of the above in that setting?
- [04:39]
C
Yeah, like most organizations, we have a pretty strong governance infrastructure around the development of our technology services. We're blessed to be part of WVU medicine and because of that we are able to have advancements in technology that many small organizations that are independent or standalone don't get the opportunity to have. But we've integrated AI into our physician practices and it's one of the most amazing things for them because their direct face to face care now is much different. So we're serving the patient more than the computer in that environment. And as we build and grow, we think our way through and develop strategies that would enable us to really provide the academic medical center level of care at our small hospital. And I think that that has been a hallmark of how we decide what we're gonna do and how we're gonna move forward.
- [05:34]
B
I'm gonna pull that thread a little bit. So you say as part of WVU medicine, you have, we have many critical access hospitals out there, as you alluded to, that are standalone on their own. I'm sure you think about that. I know there's pros, I know there's cons, but how would you approach that if you didn't have the WVU medicine as that, as that kind of feeder of some of those technologies?
- [05:55]
C
A great example is this program that we were recognized for with the virtual ICU program. Very low cost infrastructure, just with some very simple tablets. We implemented a virtual ICU program where we were able to care for patients. We partnered with a larger organization, which is Ruby Memorial, part of our own health system, but you could do that with any other academic medical center that you work with. And basically what we do is we created a partnership where they can monitor our patients. The surgical intensivist in their ICU and critical care intensivists can care for our patients through just a very simple virtual hookup. This infrastructure actually I think cost about $5,400 to implement. So it doesn't have to be rocket science and it doesn't always have to be complicated in order to be successful. I would also say for me, I've been the independent organization and we had to make some decisions about making sure that what we provide is as close to the state of the art as we can possibly get. And even so, I would say the most important thing for us is that nothing is going to take away from the face to face care for the patients with our providers. And so we try to enable them to be able to, to care. And so even with some, when we had antiquated technology or antiquated IT systems, we still were able to utilize Dragon and other scribing techniques that would try to keep the providers at the as close to the bedside as possible.
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B
So you have 25 beds you described, obviously a lot of very key specialists and talented people there. In those 25, at any given time, how many people are in the icu? I'm just trying to parse out a little bit more how you, you know, what you won the award for and exactly what you're doing so it can inspire some others.
- [08:00]
C
When I started there, the ICU was closed and all the equipment was draped with towels or Sheets, basically the lights hadn't been turned on for about 18 months leading up to this. I think we just decided that no matter what, this ICU needs to be open. It needs to be open for this community. And so we're going to figure out a way to make it work. And we took this pilot program to the health system and said, look, hey, if we were able to partner with you, what that will also help us do is keep our patients local so that we don't have to transfer as many patients out, which would help the health system with overcrowding and very high census, which is what we are all living through today. We opened up the icu. Basically we had to make some investments in equipment, new IV pumps, made sure the beds, everything was working properly. And once we implemented the virtual ICU program with the health system, we found that it created an environment where the hospitalist felt much more safe and secure and supported to be able to admit more patients. And therefore it drove the census up quite a bit. So when we started, there was an ADC average daily census of two patients where we're in the hospital on my
- [09:21]
B
first day and now overall are in the ICU.
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C
Yes, in the entire 25 bed hospital.
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B
Okay, yeah, that's a small census.
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C
Yeah, there was, it was pretty empty. And so now I would say a good 70 to 80 days a year. We're at 100% occupancy. The ICU is always full now at this point and you know, we combined this implementation for virtual icu, which is different than any icu, and we combined it with a pretty rigorous performance improvement in our emergency department. We've got our door to dock time down around 10 minutes and we've got our door to bed time within like four minutes. So basically when you come in, you register, you go right to a bed. And so that requires a pretty significant community of people that are working together to make sure that the rooms are turning over fast. And we went from about 12,000 visits in the emergency department a year, five years ago, we're up now around 22,000 visits in that same emergency department. So obviously we're expanding, we're investing in the community and growing and developing. But we had to create the service that people wanted. And people do want convenience, they don't want long wait times in the emergency department. And I think that combined with the virtual icu, meaning that there would then be admissions in a way to create the admissions into the facility, those two things combined were pretty significant change initiatives.
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B
So you must have gotten really positive Feedback from the community, I would imagine in terms of that ability to stay local.
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C
Oh my goodness, yes. The community is rallied around the hospital. When we have events. We just had a ribbon cutting for a new building. Honestly, it was standing room only. The community has been wonderful. And I think like every community, our community just desired to have a great hospital and one that they could rely on. And I think that this program and our service and our caring toward really wanting to just do the right thing and always be that organization that would care for every patient like your own family. That is our North Star. So those things resonate with people. They resonate with the employees that work here. And our reputation built. I didn't have to do a lot of advertising. It really happened by word of mouth, just by the fact that we were a different organization. And it's funny, Mark, I'll tell you, one of the things that was really interesting is just renovating and putting in new flooring and painting walls and making the place look different. Also created a lot of excitement in the community that they knew a new day was coming. There was going to be care and investment back in their, in the local hospital.
- [12:14]
B
So this is really a win for everybody. The community loves it. The patients get really top notch care. The doctors there feel more comfortable taking care of somebody sicker knowing they have probably pretty immediate backup to make decisions and manage critical patients. And it decompresses some of the referral center that, that. So when you do have somebody you need to move or other places need to move somebody because they still need that referral center, it's more likely to get them in there, I suspect. So it's been a, it's been a win on all rounds.
- [12:41]
C
It's a win, win all the way around. And I'll tell you, one of the, one of the unique things is that our physicians who were the hospitalist team, once they really started admitting patients and they started to feel more secure by having that safety net with the virtual icu because if the patient ever then decompensated, they could just go right into the virtual icu, they'd get additional help and a consult. Once that happened, it's interesting, there began to be mutual learning in both directions. And our health system is so awesome. And in that there's a great deal of humility on both sides of our organizations that they actually learned some things from our hospitalists and our hospitals learned a lot from them. So it was a great mutual learning opportunity and just a really wonderful partnership of working together in a really positive way.
- [13:35]
B
Hospitals Always, I think, are pillars in their community and Senate. But in a rural environment where when you have a hospital that people can be proud of, I mean, they rally around. And it's such a core part as an employer, as a caregiver, I mean, so critical to the United States that we have amazing rural hospitals like yours.
- [13:53]
C
Oh, thank you for saying that. And I would say it's very important that we continue to support our rural hospitals and our local hospitals, this hospital, just by simply growing and having a North Star of caring for patients and opening practices and bringing a lot of different specialists in. And again, that list I gave you was just a short list. Those things are really important also for the economic engine of the community. This hospital created 300 jobs in the town of, in Mineral county, in the town of Kaiser, so that we, you know, we have a bigger tax base as an organization, we have come a long way. And I think this is an important part of the American Hospital association with the work that the hospital association is doing to really help hospitals be strong and be healthy. It's just amazing work. And like you said on the stage, it's God's work to. To make sure that we're caring for patients and that we're really doing the work that is healing and helping people. And so I've never actually worked a day in my life, to be honest with you, because I was doing what I was called to do in my life.
- [15:00]
B
That's great. That's amazing. Well, you know, let me ask you this then. For the next aspiring rural hospital leader who wants to implement some of these, any lessons learned and then what's next? I mean, where are you going next? From an innovation standpoint.
- [15:14]
C
Yeah. Thank you. I think from a lessons learned perspective, I think that one of the things that I would say for me is just making sure that I always approach things with an open heart and an open ear and an open mind. The way that I conceive things as a leader doesn't always mean that's the right way to do things. We had some big lessons learned, I think, also around technology. What we expected for it to cost and what it had to be. No, actually, it didn't need to be like a million dollar price tag on this. And we actually were able to implement this just by opening up various portions of Epic and then also utilizing simple tablets. And I think that sometimes we think it's a much bigger obstacle to jump than it actually is. And I think once we believed we could do it, we could. There was nothing that could stop us. So I think as soon as we had the faith in ourselves and that we learned that we can do it, we did do it and we did accomplish it. I think for our future, we're going to continue to grow the utilization of AI and really try to keep the documentation work that's being done through AI and through a bridge. And the technology that we have today keeps the physicians much more happy and satisfied with their care because they're really spending time with their patients now versus serving a computer. I think that's been a wonderful thing for us. And I would say that making the investment in technology is really paramount to where to success in today's world.
- [16:58]
B
You're working towards that North Star. You're seeing it as never working a day in your life. This is a very impressive program. I see 100% even more in detail now why you've won this award. And I think it's an inspiration in many other hospitals. So thank you for your time today. Thank you for your perspective and your commitment. I really appreciate you being here. And as I close, I want to amplify a comment that I made at the Rural conference. I was glad you were listening when you said the God's work part. And that's really we need to work together as hospital leaders to be defined not by the challenges we face, but instead by how we overcome them. And that's precisely what you have done. And congratulations to you and your team. Thank you everybody for finding some time today to listen. We'll be back next month for another leadership dialogue conversation. Thanks so much.
- [17:46]
A
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