← Becker’s Healthcare Podcast
Becker’s Healthcare Podcast
Amy E Lee, MBA, MBHA, MJ, FACMPE - President & COO at Nantucket Cottage Hospital
00:13:31
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- [00:02]
A
@ Athenahealth, we know your ambulatory practice wants healthier a healthier business, healthier care teams and healthier patients. But the complexities of modern healthcare tech make it hard for you and your care teams to focus on what matters most. That's where athenahealth can help our AI native all in one solutions reduce administrative burdens, streamline billing and payments, and deliver critical insights when clinicians need it most. That means fewer clicks, more time for patients, and stronger bottom Practicing medicine is complex, but running a practice can be that Much simpler with Athenahealth. See how simpler is healthier at athenahealth.com.
- [00:44]
B
Hi everyone. Welcome to the Becker's Healthcare Podcast. My name is Scott King, joined today by a wonderful guest, Amy Lee, President and Chief Operating Officer at Nantucket Cottage Hospital. Amy, how are you doing today? Thanks so much for joining us.
- [00:59]
C
It's a beautiful day on the island. Thank you for having me.
- [01:03]
B
That's hard to beat Chicago. It's pretty gloomy here today, so certainly not like a beautiful day on an island. But I appreciate you joining us. Avi, before we dive into the questions we have for you, I just wonder if you could please just kind of tell us a little bit about yourself and your background.
- [01:18]
C
Sure. So I've been in healthcare my entire career. I actually started at John Deere Health a very long time ago in Illinois. That was before they or that is when they had health care so they had primary care and insurance. I worked for them for 10 years before they sold to United Healthcare. I've been a variety of other places including Vail, Colorado for Vail Health, Carle Health in Champaign, Illinois and then I was also in Maine before I came to Nantucket.
- [01:48]
B
Appreciate you sharing that background info. And as someone who went to U of I always great to hear about Champaign, but just curious, with your background and your work in health care right now, what do you see as your, I guess, your biggest priority and biggest part of your role as a COO with your system?
- [02:08]
C
So Nantucket Cottage Hospital is part of Mass General Brigham, so we're part of a much, much bigger system, but we are a community hospital on an island 30 miles out to sea. So it's a very different life than it would be, you know, for the academic medical centers and that kind of thing. So for my, my role and my biggest responsibility, it's really ensuring that our tiny but very sophisticated hospital can deliver very high quality, compassionate care to our patients, but also supporting a community that is 30 miles out to sea. You know, you have your day to day Operations, all those things at every hospital has to do. But we also have know a seasonal community that goes from 24,000 to over 80,000 a year. We have, you know, just very interesting way of doing things here. We are the second largest employer on island and many, many people rely on us in order to live in this unique setting. So it's so much more than the four walls of our hospital. We also, you know, we're huge community partners to address challenges like workforce, housing, seasonal surges in population, access to behavioral health and specialty care. You know, just all those different challenges. So it really means thinking long term, investing in technology and solutions and partnerships so that people can really remain on island for their care and for just the quality of life that they're looking for.
- [03:33]
B
Certainly a unique situation with a health system on an island. I'm just curious if you can kind of dive into one of, I guess the, the tricky technical aspects of running the health system on an island, right?
- [03:45]
C
Yes. So, you know, we have a very, very strong primary care team. We have specialties, but we also bring 38 specialties to the island because we have a population that won't leave or we have, you know, seasonal visitors that really just want to be here for the summer and they still need their care, whether it's oncology, cardiology, you know, all the ologies. So we, we really invest in and make sure that we have the resources either virtually or on island to provide for those patients. We also have. One of the things I'm very, very proud of is that we take care of 97% of the patients that walk through our doors. We are able to really take care of their health care needs. Only 3% get transported off island and that's generally by helicopter or plane. So again, it's a very unique setting in that we have to make sure that if there's weather, if there are some type of event, we can still take care of patients and stabilize them until they can be taken off island. So we have to have that incredibly high quality, talented team that can care for patients here. But that connection to Mass General really gives us the ability to take it to the next level.
- [04:51]
B
Just in staying with that. I mean, when you, when you talk with other COOs and you ask, you know, even if it's just in your head, you kind of measure up everyone's role and their duty, maybe even day to day, do you think you've just developed some great like problem solving skills and being able to think quickly and address things, being with the situation you have?
- [05:12]
C
Yes. You have to, you have to be very flexible. You have to think on your feet. I had the same situation when I was in Vail, Colorado. There it was mountain medicine. The passes would close. You couldn't fly somebody out here. It's island medicine. You just have to have, you have to hire talent that really understands that they have to be flexible, they have to be critical thinkers and be very creative in the processes. We do a significant amount of process improvement. And one of the things that the team is incredibly proud of, and so am I, is that for our urgent access, we have a walk in urgent access that has that seasonal swell so they could see record number of patients any given day. But from the time a patient checks in to when they see a provider is less than eight minutes on average. In our emergency department, from the time the patient checks in to seeing a provider is less than 15 minutes. And the team's really committed to making sure that those wait times were so small. And they are focused on those processes and improving those pieces to get that patient back, to get them really taken care of. Because every minute counts because we don't know what's going to be walking through the door. You know, part of that is an investment in increasing the number of providers that we have, the time they can spend with patients, those kinds of things. But it's really the team itself, they are so invested in taking care of the patients that it's all that continuous process improvement and making sure that if they see an issue, we address it immediately.
- [06:34]
B
What do you think your biggest accomplishment is with your system in the past year?
- [06:38]
C
You know, we've made a lot of significant changes, not just in our patient care, in our quality metrics, those kinds of things, but investing in our workforce. So one of the things that I'm very proud of and I think has made a significant difference is really looking at what our employees need, what do they need in their lives that will make them really focused on the care of our patients because they don't have to worry about certain things. So we've invested significantly in housing, in education and community outreach, those things. So that way we're taking care of those day to day things so they can focus on the patient. You know, I never knew coming, coming here that 30% of my time would be spent on real estate. But in a place where the average home price is three and a half million dollars, you know, there's very few people that can afford a home. So we have to really think about how we're going to make sure that we're housing our caregivers. And we hired a seasonal care coordinator and his full time job is to work with our employees to make sure that they have a solution for housing. Because it's not a one size fits all, it's not a house or apartment. There might be so many other different things that they need so that that person really helps with the, the housing solutions for our people.
- [07:52]
B
I think that's a fantastic resource for staff. I, you know, it'd be great if more systems develop something like that. I also want to ask what your organizational goals were for 2025 and how your system's kind of tracking with those goals.
- [08:07]
C
Sure. So we have all the normal quality goals and those kinds of things that we always focus on. But we also really wanted to expand behavioral health access through in house services, through vendor supported crisis management, telepsychiatry on island providers and just a wraparound community support just to make sure that there were many solutions for our patient population. And in the three years that I've been here, we've seen a significant number of behavioral health patients come through our doors and, and we know we have to address that situation. And it's, it's not again it's not a one size fits all. It's how do we really look at all those different pieces that put it that are coming together to make sure that we're taking care of the patient holistically. And behavioral health is a tricky one, you know, especially with the, the way it's get it gets paid. And so we have a lot of solutions that are payer blind or you know, it doesn't make a difference if they can pay or not. We're still going to take care of them because it's, it impacts the health of the entire island. Food security is another one. Again, it's one of those things you know about it peripherally but really understanding that food insecurity has such an impact not just on our patients, but on our employees. So really looking at how we can improve the food models here and either you know, through Food is Medicine, which is the Fresh Food Prescription program, partnership with local nonprofits, all those other pieces to really make food more accessible. One of the things that we just had an article in the paper about is we raised our, our cafeteria prices for the first time since 2018 and we had to, we had to cover the, the food supply costs. But we did it as minimally as possible because we realize our cafeteria feeds not just our patients, but it feeds our staff, it feeds our community. And in, in Those lonely dark winter months when there's not many people on island. It's also a community gathering place where people come, they have fellowship, they get a really good meal and to take home so that it's truly, you know, a resource that is providing much, much bigger than just a normal hospital cafeteria. We, like I said before too, increasing access to specialty care through the visiting physicians, the training of our local team, telehealth, teleconsult, all those things. It's really incredibly important. And now we're up to 38 specialties, which is a huge number. But again, you know, even the little ones, like infectious disease, we only have 100 consults a year. But for 95% of those patients it means that they could stay on island and that's a really big deal, especially when traveling off island is very expensive. We've implemented a lot of AI to really help reduce the clinical burden for our providers and they've embraced it. They enjoy those pieces that allow them to sit and talk to the patient while things are happening in the background. And there's still that administrative burden, but it's much less than it used to be. And we have a lot of buy in from our providers and our staff because they see that impact.
- [11:10]
B
Well, it sounds like you made some fantastic progress on, on your goals there. Just curious, what do you see as your system's kind of headwinds or challenges or maybe even the industry for the next year or so?
- [11:22]
C
You know, we've been very, very lucky when it comes to recruitment. So our headwinds are really retention and housing and just the cost of living in general, making it prohibitive for people to live on an island that is, is, you know, it's difficult and you have to have a passion for it. And, and when you have just one more worry, we have to make sure that we're really working on that so that we can keep our people. Because you know, even our really highly mission driven staff, they struggle to stay on island without affordable stable housing. And we have this thing called the Nantucket Shuffle where it means that they have some staff that are moving two to three times a year because they're short term leases and they expire. And you know, when you have that type of housing insecurity, it's just, it's really hard to focus on your job. So you know, with inflation, the rising healthcare costs, the mental health demand, those are all outpacing our resources, but we really have to stay on top of those to make sure that we're taking care of our staff. And our patients.
- [12:21]
B
The last question I have for you, Amy, wanted to ask how you think you're evolving as a leader.
- [12:26]
C
You know, one of the things I've learned over the years, but it's very enhanced on this island, is that solving our healthcare challenges, it requires collaboration. We can't do it on our own. As a community hospital, having a partner in Mass General is such an advantage. It's like having a superhero, big brother. That's really helping us with taking care of our patients, but it's also working in our community with our civic leaders, our community health partners, the nonprofits, our donors and our patients to make sure that we have a system that works really, really well to take care of everyone. And we have so many people that have these great ideas that they bring to us, and we figure out how to implement them in the community because it's not always just the hospital, but that helps everyone. And it's very gratifying because you see those results very quickly.
- [13:19]
B
Well, Amy, thank you so much for joining us on the podcast today. I think it was a great conversation. I look forward to working with you again soon.
- [13:25]
C
Thank you. I appreciate your time.
- [13:29]
A
At athenahealth. We know your ambulatory practice wants healthier, a healthier business, healthier care teams, and healthier patients. But the complexities of modern healthcare tech make it hard for you and your care teams to focus on what matters most. That's where athenahealth can help our AI native all in one solutions. Reduce administrative burdens, streamline billing and payments, and deliver critical insights when clinicians need it most. That means fewer clicks, more time for patients, and stronger bottom lines. Practicing medicine is complex, but running a practice can be that much simpler with athenahealth. See how simpler is healthier at athenaheal.