As Methodist Grows, Consumer-Focused Care and Patient Access Are Priorities

Pulmonologist Sumit Mukherjee, MD

Marilynn Fidler has never met her pulmonologist in person, but she credits him with dramatically improving her life.

Marilynn, who has end-stage COPD, had been traveling from her home in Glenwood, Iowa, to Council Bluffs for treatment. When Sumit Mukherjee, MD, of Methodist Physicians Clinic Council Bluffs began using remote technology to see patients in Red Oak, where Marilynn works, she decided to give it a try.

“I feel very blessed that I did,” said Marilynn, the first Red Oak patient to see Dr. Mukherjee this way. “He’s taken very good care of me. He has excellent rapport. The things that he’s done with me through the medications and the treatments have made a dramatic change in my life and my lifestyle.”

Patient outcomes like hers were one of the goals when the Red Oak telemedicine outreach began last summer. The program also illustrates how accessibility and convenience are priorities as Methodist Health System grows to meet patient needs.

Consumer-focused Care and Accessibility

New facilities, more providers and the recent addition of Fremont Health are key to the health system’s growth strategy, but efforts that may not generate headlines are just as important.

“Our growth is planned around primary care. That’s how patients access the system in the metro area,” said Steve Goeser, president and CEO of Methodist Health System. “It’s also extremely important that we develop relationships with the rural hospitals around us in western Iowa and eastern Nebraska.”

The overarching goal is to become more consumer-focused and give more people access to care. Sometimes that means growing in familiar places. Other times it means going to the patient.

Fremont Health Partnership

The two health care organizations signed an affiliation agreement in July, creating Methodist Fremont Health. The partnership adds valuable services like Medicare home health and skilled nursing to Methodist Health System. Fremont’s behavioral health services will complement the program already in place at Methodist Jennie Edmundson Hospital. 

Beyond having access to Methodist’s deep pool of specialists, Methodist Fremont Health will benefit from efficiency and savings through Methodist’s electronic health record technology and IT security. 

“At the individual patient level it might be hard to see, but it actually makes the health system stronger,” Goeser said.

By spreading costs over a larger base and adding revenue, Methodist can invest in equipment and technology – things that often prove invaluable for a patient’s well-being.

“Having a good strong system that you can rely on for that kind of capital ensures that we can meet the primary needs of the individual patient.”

Steve Goeser

President and CEO of Methodist Health System

As the demand for primary care increases, Methodist has responded. Of note:

• The Fremont partnership adds five OB/GYN doctors, four internal medicine doctors, two family medicine doctors, four advanced practice registered nurses and a physician assistant providing care at clinics in Fremont and outreach locations in North Bend and Dodge.
• Four new internal medicine doctors are now seeing patients at Methodist Physicians Clinic Cass Street, which opened in February at 8019 Cass St. in Omaha. 
• More exam rooms were recently added at Methodist Physicians Clinic Gretna, allowing for the addition of one or two primary care providers. 
• More space will soon be available for new primary care providers at Methodist Physicians Clinic Indian Hills after a private practice ends its lease this spring.

Methodist Jennie Edmundson Medical Office Building

Across the Missouri River in Council Bluffs, work has begun on a 60,000-square-foot medical office building on the busy Methodist Jennie Edmundson Hospital campus. When complete in 2020, the building will have clinic space for approximately 15 primary care providers and be home to an urgent care facility. It will also be a hub for women’s services by:

• Housing Methodist Physicians Clinic OB/GYN providers and additional independent providers.
• Having imaging capabilities including mammography, ultrasound and DEXA bone-density scanning.
• Including space for Methodist Women’s Hospital maternal-fetal medicine specialists and potentially other specialists.

“It will provide accessibility and convenience in a familiar location,” said Jeff Prochazka, vice president of strategic planning and business development for Methodist Health System. It will also “decompress” the campus, he said, paving the way for future growth.

Hospital Expansion 

The expanded Neonatal Intensive Care Unit at Methodist Women’s Hospital opened in 2017 and Methodist Hospital’s operating room expansion was completed in 2016. 

Now Methodist Hospital is in the midst of an effort to expand its Emergency Department, which saw over 28,000 patients in 2018 and has experienced a more than 20 percent increase in patient volume over the past five years. The $25 million project will double the amount of patient rooms to 24, improve ambulance access and add parking, among other additions. Construction is expected to begin this year and take about three years.

Outreach Across the Region 

Whether it involves using technology or traveling to smaller communities, outreach is critical to Methodist’s strategy of meeting patients where they are.

Among the efforts:

• Cardiologists treat patients in Fremont, Blair, Osceola, St. Paul, Creighton, Osmond, Plainview, Red Oak, Denison, Harlan, Atlantic, Glenwood and Hamburg. They also travel outside of Nebraska and Iowa to see patients in Fairfax, Missouri.
• Maternal-fetal medicine specialists from Methodist Women’s Hospital Perinatal Center offer their services on-site in Council Bluffs, Hastings and Grand Island while using telemedicine technology to read ultrasounds from other areas. 
• Dr. Mukherjee uses telemedicine tools to see patients once a month at Red Oak’s Montgomery County Memorial Hospital. He also travels to Myrtue Medical Center in Harlan, Iowa, twice a month.

“That creates ties with those communities and opens the door for specialty care to be provided here at Methodist,” Goeser said.

Dr. Mukherjee is on the front lines of the outreach strategy, using video technology to communicate with patients like Marilynn and Ronda Daffer. 

“It’s just like he’s actually there,” said Ronda, who lives in Red Oak. “It’s not any different than having a regular doctor’s appointment.”

When it’s time to listen to the heart and lungs, Dr. Mukherjee uses an interactive stethoscope held by staff.

“Quite honestly, the sound quality is just as good as if I was listening to my own stethoscope,” he said.

All this from his office over 50 miles away. 

Dr. Mukherjee schedules in-person follow-ups with some patients, but “most of the time we’re able to do everything over the computer.” 

Health Care on a Personal Level

Whether adding facilities and providers or taking services to patients, Methodist’s growth is guided by a commitment to doing what’s best for the people it cares for.

“Care comes down to that personal relationship with your provider,” Goeser said. “You should be comfortable with them and rest assured that they’re meeting your needs, whether it’s a chronic disease, a surgical issue or simply preventive care.”

Marilynn said she feels fortunate for the opportunity to see Dr. Mukherjee from Red Oak. Beyond the reduced travel, there are a lot of little things that make a big difference for someone managing COPD – things like avoiding vehicle fumes in covered parking lots and possible illnesses in busy waiting rooms. 

And then there’s the expert care. Marilynn had six flare-ups of her symptoms in the eight months before she began seeing Dr. Mukherjee. She’s had only one since. After her most recent appointment, he ordered a low-dose CT scan and pulmonary function test. He has also helped her with the process of getting on the lung transplant list.

“One of my mentors once told me, ‘When you can’t breathe, nothing else in the world matters,’” he said. “I try to remember this when caring for my patients.”

That approach means the world to Marilynn.

“I can’t praise him enough, nor the system the way it works,” she said. “I get excited when I think about all of the positives that it brings to my life.”

More resources

• Read the latest Methodist Health System news
• Read more from the Spring 2019 issue of The Meaning of Care Magazine