- To respond to the novel coronavirus outbreak, New York City Health + Hospitals created three new field hospitals and converted emergency room, post-operative and procedural areas to handle intensive care beds in its 11 existing facilities, according to a series of Health Affairs articles chronicling how the health system dealt with being at the heart of the COVID-19 pandemic's early presence in the United States.
- NYC H+H went from billing an average of 500 telehealth visits a month to nearly 83,000 as it shifted focus to virtual care starting in March. The system's patient portal handled a surge of more than 13,000 patient messages from March 30 to May 15, according to one of the articles published online late last week.
- To deal with the increased need for staff, NYC H+H used private staffing agencies, partnered with the Department of Defense and recruited volunteers from across the country. Within a two-month period, the system took on 20,000 employees, including 9,000 nurses, using a new portal that gathered educational tools focused on COVID-19 content.
The peek inside NYC H+H's response comes as all states are in some phase of reopening, and worries mount about COVID-19 surges in regions early to lift stay-at-home restrictions. Several states are reporting record levels of positive tests, including Arizona, where Banner Health executives have warned hospitalizations and ventilator usages are on alarming inclines.
Although the Trump administration has prodded systems to restart elective procedures delayed in recent months to prepare for surges of COVID-19 patients, public health officials are warning Americans not to let their guard down.
"We are not out of the woods yet," Centers for Disease Control and Prevention Deputy Director for Infectious Diseases Jay Butler told reporters Friday. "In the coming weeks we could see increases in the number of cases of COVID-19 as states reopen and as there is an increase in public gatherings as we move into the summer across the country," though "it's too soon to tell."
New York City was one of the first major hotspots in the U.S. and had 193,000 confirmed cases of COVID-19 as of May 22 — with more than 50,000 requiring hospitalization.
NYC H+H, the largest safety net hospital in the country, operates in parts of the city that house populations hit hardest by COVID-19. Nearly 70% of the system adult patient population is uninsured or covered by Medicaid.
Early into the pandemic, NYC H+H staff realized huge and rapid changes would be needed. "The direction from our system president and CEO was clear: each of our system hospitals, with their more than 4,000 total beds, would need to prepare to become a single large intensive care unit," they wrote in Health Affairs.
Regulatory changes from CMS aided the push, including waivers that allowed Medicare to cover telehealth services and gave systems flexibility to perform hospital-level care outside a facility's four walls.
NYC H+H also created a hotline staffed by clinicians to provide guidance to New Yorkers, connect them with social services and register them for home system monitoring. It launched on March 11 and as of May 1, the hotline had fielded more than 90,000 calls.