For the last two years, Motient has helped hospitals streamline patient transfers and partnered with teams to support patient care through the Mission Control platform and logistics services.

Unfortunately, Motient’s Mission Control is unable to continue operations beyond Dec. 31, 2022.  At that time, the Mission Control software and logistics services will no longer be available to hospitals.

The team at Mission Control is grateful to have had the opportunity to partner with hospitals and patient care teams across the country.  We are proud to have been associated with many great hospitals and frontline caregivers that repeatedly demonstrated expertise, compassion, and care for those often in crisis.  It has been our pleasure and an honor to support the health care community with our services, expertise, and technology.

If you are currently a Mission Control user and need further assistance during this transition, email contact@motient.io and a Motient team member will assist you.

Motient, a pioneer in patient movement solutions, announced today that Rice County District Hospital (RCDH), a critical access hospital in rural Kansas, has reached a two-year milestone using its Mission Control platform. For the past two years, RCDH has relied on the patient movement and communications platform to broaden its reach and secure appropriate care for critical patients. RCDH has a track record of success using Mission Control to expedite emergent patient transfers, secure specialist consultations, and coordinate interfacility transport across a large geographical region.

As a 25-bed critical access hospital, RCDH provides emergency services to residents of Rice County and the surrounding areas, with a lean staff of 160. The facility is a designated Level IV Trauma Center, and acts quickly to stabilize critically ill or injured patients before transferring them to a higher level of care at a larger hospital. Without a surgeon in-house, approximately 40% of RCDH’s patients require a higher level of care facility transfer.

In May 2020, RCDH implemented Motient’s Mission Control platform as part of the company’s partnership with the Kansas Department of Health and Environment (KDHE) to manage emergent patient transfers. All state hospitals had access to Motient’s patient movement software and services to find available beds, arrange appropriate transportation, and streamline the patient transfer process.

“Implementing Mission Control was like gaining another two team members. The system performs all the patient transfer-related administrative tasks that our physicians and RNs previously did,” said Bonnie Goans, RN, trauma/emergency preparedness coordinator at Rice County District Hospital. “Now we can quickly coordinate transfer and transport across greater distances, making our world smaller and giving patients more and better options for care.”

When COVID-19 surges strained hospital capacity across the state, the two Level 1 trauma centers that normally received RCDH’s transfer patients were routinely on diversion, with no available beds. The team would spend hours calling potential receiving facilities in search of an available placement, starting with the ones closest to RCDH and working their way out. With just a few clinicians working each shift, this time-consuming process had a negative impact on patient care at the bedside. During the pandemic, Mission Control helped RCDH transfer patients to facilities in seven states, including Oklahoma, Colorado, Nebraska, Iowa and Missouri.

Implementing Mission Control has broadened RCDH’s patient transport reach, expedited patient transfers, and improved inpatient care. As soon as the team receives a patient report from its Emergency Medical Services (EMS) agency, they assess the acuity of the patient’s condition in Mission Control. The Motient team handles the search for an appropriate bed placement, and coordinates with hospital administrators to authorize and confirm transfer and transport.

If the RCDH team requires additional expertise while patients are awaiting transfer, Motient quickly connects them with cardiology, neurology, pulmonology, and other specialists for immediate telemedicine consultations.

When the transfer distance is greater than 90 miles, RCDH’s local EMS agency cannot take the patient, as the trip would leave the community without ambulance care. Motient then works with multiple ambulance services and flight companies to identify the fastest, safest method of patient transport, whether it be ground, helicopter, or fixed-wing aircraft.

“It’s amazing how fast we can get transportation to our hospital using Mission Control,” said Goans. “Our new ability to coordinate transport to facilities that are farther away and even out of state has given our patients transfer options they would never have received otherwise, which truly saves lives.”

For the 20% of America’s population that lives in rural areas of the country, accessing emergent care can be challenging. Due to financial constraints and thin margins, more than 130 rural hospitals have closed within the past decade, and 30% of the remaining rural hospitals are at imminent risk of closing.

Motient’s patient movement platform helps critical access facilities like RCDH establish universal workflows and standardized acuity assessments for emergent patient movement, which enables more effective care management. Facilities are often able to keep more of their lower-acuity acute care patients, which helps provide needed revenue.

“Our nation’s rural healthcare system depends upon strong collaboration between facilities, as we’ve seen firsthand during the pandemic. But without common infrastructure or shared patient movement data, it becomes difficult to match the right patients with the right system resources,” said Dallan Huff, president of Motient. “We’re proud to help vital critical access hospitals like Rice County access specialist care for their patients in need. Mission Control helps to ease the logistical burden of care coordination, which is essential for keeping emergent care available to rural Americans.”

To hear Bonnie Goans discuss RCDH’s patient transfer process in detail, listen to her interview with Sue Schade, principal at StarBridge Advisors, on ThisWeek Health’s Town Hall podcast.

The Kansas Department of Health and Environment (KDHE) collected and monitored statewide disease activity and resource utilization through Motient’s Mission Control, a web-based patient movement platform which tracked facility capacity status. In 2021, the platform was used by 122 Kansas hospitals to facilitate more than 5,000 patient transfers to 209 destination facilities, some of which were outside of the state.

KDHE used this patient movement data to help educate state policymakers on the capacity limits of the ecosystem, objectively demonstrating the need for action. The data helped leaders justify and enact mitigations to expand hospital and long-term care center capacity, including engaging the Federal Emergency Management Agency and the Veterans Health Administration to provide short-term medical treatment for transferred patients.

Read the full article by John Sittser, director of analytics and business intelligence at Motient.

When a patient presents at the ED with signs of a stroke, every second counts. Rapid detection and treatment can increase a patient’s chance of survival and decrease long-term physical and mental complications.

According to a recent study, researchers report that each one-hour treatment delay of a patient with severe stroke correlates with an 11-month loss of “healthy life.” John Hopkins Medicine also outlines how delayed treatment contributes to life-altering conditions like speech and language processing, memory issues, depression, limb weakness, paralysis on one side of the body, and trouble swallowing, depending on the region of the brain affected by the stroke. 

Time is of the essence, but expeditiously delivering the appropriate care to stroke patients can be challenging, particularly for America’s rural community and critical access hospitals. These facilities typically don’t have the neurological specialists on staff to assess symptom severity, nor are they equipped to fulfill the care needs of patients suffering from massive stroke. Caring for stroke patients in these settings typically involves stabilizing the patient and getting them to a tertiary facility as quickly as possible. A standardized acuity index and centralized patient movement platform is essential to accelerating this process.

Stroke Assessment and Treatment Protocols

Treating people who experience stroke symptoms requires an enormous amount of medical expertise from physicians. When patients are transferred to a facility by air, in the pre-hospital treatment phase, flight paramedics and registered nurses rely heavily on orders from physicians and nurses at the receiving hospital.

NIH Stroke Scales includes a battery of questions that helps the medical team assess stroke severity. While stroke scales give an initial picture of a person’s physiological symptoms, neurologists need to see brain images to make a full assessment and diagnose stroke.

To treat stroke, thrombolytic medications help dissolve blood clots and restore oxygen flow to the brain.

• TPA tissue plasminogen activator, administered with IV
  • Given within three hours of symptom onset [Source: Mayo Clinic]

Click here to read the latest guidelines for early treatment of ischemic stroke, reported by the American Heart Association and American Stroke Association.

During a stroke, getting the patient to the CT is the top priority of the medical team, said Juli Heitman, RN, customer success & quality manager with Motient, Mission Control. She currently works with sending hospital nursing staff who use Mission Control to transfer patients experiencing STEMI, stroke, and sepsis.  Previously, Heitman worked as an adult critical care bedside nurse, clinical educator, and quality manager.

Before medications can be administered, Heitman said it is critical to consider several factors that often mimic stroke.

“Before giving a clot-busting drug, first rule out low glucose levels and obtain a completed medication history, especially other blood thinners.”  

When monitoring blood pressure during an ischemic stroke, Heitman also said the body will increase the blood pressure to maintain appropriate cerebral perfusion. Lowering the blood pressure too quickly or too much, may cause a further exacerbation of stroke symptoms. [additional source-Critical Care Trauma Centre]

[INFO BOX] Types of Strokes

• Ischemic stroke—indicates limited blood flow to the brain, usually from blood clot
• Transient Ischemic Attack (TIA)
• Hemorrhagic—indicates bleeding on the brain from ruptured artery in the brain
• Posterior stroke–three times more likely of misdiagnosis [Source:  CDC and AHA]

Prioritizing Care Means Finding the Best Facility

Prioritizing patient care when a patient shows symptoms of stroke may require interfacility patient transport. And this is especially true for people who live in rural communities with limited resources.

In rural areas, the primary care doctor-to-patient ratio is 39.8 doctors per 100,000 patients compared to 53.3 doctors for the same patient load in urban settings, according to National Rural Health Association. And the number of specialists like cardiologists and neurologists–even lower in rural areas.  

Do you have the right tools to make quick decisions about patient transfers? Let’s face it, there are many moving parts when it comes to sending patients to and from facilities. While planning and coordinating these efforts, it’s just as important to maintain high-quality patient care. At Motient, we believe Mission Control can help with both.

To conduct safe, efficient patient transfers, having access to tools like the Acuity Index built into Mission Control can make all the difference. Think of the Acuity Index as a common language that helps clinicians assess patient severity and monitor worsening conditions while deciding the best method of transport, whether by air or ground.

When a patient rapidly deteriorates and needs an urgent transfer, Mission Control also helps ease the search of finding a receiving facility with beds. That means sending facilities can expedite transfers so that patients receive time sensitive quality care from receiving facilities.

“Our goal is to supply the information and structure so facilities and hospital systems can make informed choices about moving patients from one place to another,” Richard Watson, MD, Motient co-founder said, during a podcast interview with “An Empowered Patient.”

How Mission Control Helps the Healthcare Team

• Facilitates early activation of resources and IFT
• Reduces door to needle time – ideal goal 90 minutes
• GPS tracking—real time tracking from the sky

Want to learn more about how Mission Control can help your facility ease the coordination of patient transfers while maintaining high-quality patient care? Visit Motient.io and request a demo today.

Taking a standardized approach to acuity assessments not only provides more objectivity, but also gives hospitals the data they need to make a variety of tactical and strategic decisions, from daily unit staffing to future space, specialty services, and bed capacity. 

In addition to providing clinicians with a standardized perspective of their patient populations, acuity assessments also enhance patient safety. The number of handoffs between inpatient care providers and units is a proven risk factor for negative clinical outcomes, and a uniform language of assessment can help manage that risk. 

The decision to transfer a patient to another facility reflects a myriad of considerations. Unlike much of medicine, the decision is traditionally made without the benefit of a large body of evidence. In the emergency department, a patient’s care is driven by the experience of physicians, nurses, and ancillary staff, who rely on their accumulated clinical wisdom in selecting the next step in a patient’s care. Yet when a patient is handed off to a transport team for transfer, there is often a communication gap regarding how the patient’s current condition, their care needs during transport and upon arrival, and the risk of those needs changing. 

Although patient handoffs are central to the field of medical transport, there are no national standards for patient severity of illness, or the clinician accreditation needed for that severity. According to the Association of Critical Care Transport, a national patient advocacy association, this lack of standardization presents patient safety risks that are often invisible to referring and receiving clinicians, as well as to patients and their families.

Transport staff delivering a patient to the hospital or another care setting initially seek to understand two variables: exactly how sick the patient is, and how urgently they need the care at their destination. A standardized communication framework that centers on patient acuity and uses objective language turns this universal assessment into a repeatable, organized process that can be applied to every patient across the board.

The patient’s acuity functions as the most pivotal information at a fundamental point-of-care decision point: do we have the resources to give this patient what they need, or will they require greater resources available at another facility? An acuity score allows sending and receiving hospitals to prioritize patient movement based on the time-sensitive acuity of those patients. Receiving centers can also survey incoming patients to assist in their internal bed management.

When clinicians have the common language of acuity at their disposal, the patient’s score functions as shorthand, immediately conveying the difference between patients. This utility is essential, as a score can quickly communicate the core gestalt of “how sick is this patient?” without the listener having to parse the details in that moment.

The transition to value-based care (VBC) is well under way, and accelerating rapidly. According to the Health Care Payment Learning & Action Network (LAN), 41% of U.S. healthcare payments in 2021 stemmed from value-based reimbursement models, with an additional 20% of fee-for-service payments tied to value or quality in some manner.

Traditional Medicare and Medicare Advantage are leading the way, driven largely by the Medicare Shared Savings Program, which rewards participating accountable care organizations (ACOs) for delivering high-quality, high-value care. CMS also provides specialty VBC programs that reward providers with incentive payments for the quality of care delivered to Medicare members.

For rural healthcare organizations, participation in value-based payment agreements has often been limited by eligibility restrictions, low patient volumes, and a lack of financial stability required for risk assumption. For example, critical access hospitals and federally qualified health centers are exempt from some federal programs, such as the Merit-Based Incentive Payment System (MIPS) that is a part of Medicare’s Quality Payment Program, due to a low-volume threshold.

To combat barriers to entry for rural providers who wish to participate in VBC, the Center for Medicare & Medicaid Innovation (CMMI) has created several regional models and programs used as a template by many Medicaid and commercial payers to create VBC contracts. These typically address three main concerns:

Reflecting rural patient population and volume

Residents of rural communities have a greater overall incidence of disease and disability as compared to urban residents, and are more likely to die from heart disease, cancer, and respiratory disease. In addition to facing limited access to healthcare specialists, rural residents are also less likely to be insured and more likely to live in poverty.

To attract rural providers, a successful VBC model should recognize the differences in rural patient populations and case volumes by region.  Sophisticated population health management and advanced data analysis are often not feasible for rural providers with limited resources. By incentivizing team-based, whole-person care, VBC models can have a positive impact on both cost and outcomes in rural communities.

For example, one randomized clinical trial found that the use of home-based nurse care coordination program focused on medication self-management for elderly Medicare patients resulted in a net cost savings of $296 per beneficiary per month. Another study found that a bundled acute care intervention, which paired early discharge planning, patient education, and medication management with follow-up services, decreased ED use for Medicaid patients, saving $4,295 per episode.

Establishing a data-driven culture  

Rural healthcare facilities rarely have access to the IT infrastructure required for effective population health or financial risk management, and performance data is often delayed or absent. These limitations can make it difficult to improve outcomes and reach expected parameters for traditional VBC models. Adjusting model expectations based on limited data reporting and analysis capabilities can increase the likelihood of VBC program participation for rural providers.

In December 2020, the Center for Rural Health Policy Analysis co-hosted a virtual summit of rural participants in VBC models to identify critical program elements. To increase data-driven decision-making, the participants recommended that rural facilities provide “timely and actionable performance data to allow appropriate participant responses designed to improve outcomes.”

Patient movement data can provide an immediate source of performance data without requiring additional staff for data collection and reporting. Motient’s Mission Control dashboard reflects all aspects of patient movement, including time-critical diagnoses, wait times, resource utilization, vendor relationships, service line analysis, and system leakage. This system transparency allows healthcare organizations to assess operational performance in real time and identify new opportunities to improve system-wide management.

Establishing standardized protocols for how interfacility patient transfers are handled can also enable higher quality care choices, as it streamlines the decision-making process. By implementing objective means of assessing patient acuity and risk, care teams can make better decisions for emergent patients. In a Deloitte Insights survey on VBC, less than half (46%) of physicians report following clinical pathways adopted at their organization. The authors recommend that facilities build their care management capabilities, such as risk stratification and care navigation, and provide physicians with intuitive, easy-to-use tools for decision-making.

Ensuring limited financial risk

Rural healthcare organizations are typically under-resourced, both financially and in terms of staff. A successful VBC model will recognize that rural facilities cannot assume too much financial risk, and will delineate the differences between variable costs, which are directly attributable to patient care, and fixed costs, which are required to support patient care regardless of case volume.

Reduced utilization and the avoidance of low-value care will only impact a facility’s variable costs, which are likely to represent a small percentage of a rural facility’s overall expenditures. Even if some degree of financial risk is mandated, a successful VBC model for rural facilities will link that risk to performance outcomes other than cost savings.

Rural facilities seeking to enter into VBC agreements will need to ensure that their care teams can control the measures of performance on which they are being evaluated. With careful planning and model selection, rural hospitals and health clinics can begin earning incentives for the quality care they deliver.

When a patient calls an ambulance with a condition such as a stroke, heart attack, or traumatic injury, Emergency Medical Services (EMS) protocols ensure emergent transport to the most appropriate facility for immediate treatment. However, this often isn’t the end of the patient journey. Once the patient’s condition stabilizes, they may need to be transferred to yet another facility for any number of reasons, including clinical or surgical specialization, specific testing requirements, and lack of capacity.

Historically, there has been no standardized methodology to determine where and how patients are moved in these scenarios. The decision is largely based on the experience of physicians, nurses, and ancillary staff, who rely on their accumulated clinical wisdom in selecting the next step in a patient’s care. Clinical experience is invaluable in the transfer process, but relying on experience alone can lead to oversight, risk, and unbalanced prioritization.

For example, some caregivers may simply opt for the closest available facility based on convenience and proximity—two factors that aren’t necessarily foremost in saving lives. Several other factors that must be considered to ensure optimal transfer and patient outcomes. Having a standardized communication framework that uses objective language and centers on patient acuity can turn transfer assessment into a repeatable, organized process that can be applied to every patient, reducing variability, guesswork, and risk.

An Acuity Index for standardized transfer decision-making

In a previous blog, we outlined the value of Motient’s Acuity Index, which provides a standard protocol for patient transfer assessment. The Index scores a person’s condition based on answers to eight questions that consider the current clinical workload, the present risks, a prognostic perspective of the patient, and the level of care the patient will need based on the severity of their illness. Understanding the patient’s acuity level helps providers match the transfer patient with an optimal receiving facility that can provide the necessary care.

The information gathered by the Acuity Index is weighted, and the result helps providers determine the level of care needed in the transfer process, such as crew capabilities and the recommended transport mode. Key measures calculated include the current stability of the patient, the interventions and monitoring needed to maintain that stability, and the patient’s risk of deterioration once they leave the hospital and begin their journey to definitive care. The final Acuity Score stratifies patients into groupings to aid quality departments and enhance reporting processes.

The assessment of clinical deterioration is critical in the transfer process, as a higher pre-transfer risk score predicts the probability of clinical deterioration. According to a 2020 study, the incidence of clinical decline in the interfacility transfer of critically ill and injured patients was 28.69%. The types of illnesses with the highest probability of clinical deterioration are those involving circulatory, respiratory, and neurological systems (e.g., arrhythmias, chest pain, traumatic head injury, etc.). Having a standard protocol in place to evaluate the patient’s risk of deterioration—and to adjust transfer mode and crew capabilities accordingly—is a crucial factor in ensuring the best possible outcomes.

A common language for patient movement and bed management

The patient’s acuity score functions as the baseline for transfer decisions, allowing sending hospitals to determine if a proposed receiving hospital has the resources necessary to adequately meet the patient’s needs while prioritizing patient movement based on time sensitivity. Receiving centers can also survey incoming patients to assist in their internal bed management.

When clinicians have the common language of acuity at their disposal, the patient’s score functions as shorthand, immediately conveying the difference between patients. This utility is essential, as a score can quickly communicate the core condition of the patient without the listener having to parse the details in that moment. Clinicians who are well-versed in the acuity scale will immediately understand what the score represents and can act accordingly.

Appropriate initial placement of a transferred patient can save valuable clinical time. Acuity scores can also be used to help clinicians guide bed placement decisions. For example, a telemetry bed request for a patient with a high acuity score can trigger a pre-arrival screening to clarify if a patient with high care needs should be placed on an intermediate unit.

The proximity of a destination facility is just one factor in a potential transfer decision and one that isn’t necessarily the most important. Care capabilities, patient acuity, risk of deterioration, transportation mode, and timing all impact the ultimate success of a transfer. The decision to transfer a patient cannot be made with incomplete, random, or potentially biased information. Instead, transfers must be guided by an organized assessment and decision process. This data should also be shared among all parties in the transfer process to facilitate ongoing dialogue and collaborative problem-solving.

Tools like Motient’s Mission Control can help providers streamline transfer decisions by enabling patient acuity tracking and the monitoring of hospital and medical transport logistics from a single source. Patient condition changes, ETA updates, routing changes, real-time maps, utilization, and more can all be tracked via the Mission Control dashboard to ensure clinically informed, value-based decision making. Learn more.

The ins and outs of interfacility patient transports — the processes, workflows, resources, reimbursement, and decision-making — aren’t something most people think about.

Yet how patients move within a healthcare system impacts not only the patient being transferred, but also the transport vendor and the on-call physician, as well as the hospital’s program director, board members, and local and state stakeholders. How patients move influences much more than most people think, and its impact can be seen on the national level as we look at our healthcare statistics and trends. Let’s learn a little more.

A Patient Arrives at the Emergency Room (ED)

When a patient arrives at the ED, a triage nurse assesses the severity of their condition based on vital signs, symptoms, and medical history. After triage, a physician must determine the individual’s subsequent needs: does the facility have the expertise, resources, and equipment to treat this patient? If not, the ED team might initiate an interfacility transfer.

Approximately 70% of a hospital’s inpatients are processed in through the ED, and the majority arrive by Emergency Medical Services (EMS). For the most urgent conditions — such as myocardial infarction, stroke, sepsis, and major trauma — EMS protocols specify emergent transport to the most appropriate facility for immediate treatment. But once these patients are stabilized, they might still require a transfer.

Patients often qualify for an emergent transfer to another facility because their condition requires a level of specialization or testing that the initial facility cannot offer. For example, a trauma patient who requires surgery might be transferred from a critical access hospital (one with 25 or fewer acute care beds) to a Level I trauma center. Before the COVID-19 pandemic, smaller EDs averaged the highest transfer rates, at approximately 5%.

Patients can also be transferred due to a lack of capacity (which is happening much more frequently during our current staffing crisis), patient preference, or insurance coverage issues. In non-emergent situations, a patient might require transfer for elective surgery, to be closer to home, or to move to a more suitable environment in order to free up capacity for high-acuity patients.

The Patient Needs to Be Transferred

Time-critical cases require fast consideration of the patient’s clinical situation, current needs, potential outcomes, and the available resources. Facilities must have standardized processes in place to quickly evaluate their capacity for accommodating a patient who requires a higher level of care. Hospitals can use acuity scores to prioritize which patients should be first on the list for a transfer, ensuring that low-acuity cases do not inadvertently bump higher-acuity cases down the list.

Hospitals must also have strong connections with other hospitals within the region, as they will need to locate and confirm an appropriate destination. When bed capacity drops across a region — such as during COVID-19 — finding a facility that can receive the patient can be a challenge. Clinicians sometimes spend hours on the phone, calling half a dozen facilities or more in search of a bed. For facilities using Motient’s Mission Control solution, the process is much easier. Clinicians simply enter a pending transfer into the application and continue caring for patients, as the Motient team will contact them once an appropriate, available destination is confirmed.

What kind of prep work must be done?

Once an appropriate placement is found, the ED team must coordinate the logistics of safe, reliable patient transport. The team may need to contact multiple transport vendors, as some may be unavailable, or may lack the capabilities for safe transport for certain patients. An incomplete understanding of the patient’s condition can lead to inadequate resources during transport, and thus to adverse events.

Throughout the transfer process, physicians at both the referring and receiving hospitals must be updated about any changes in the patient’s status. There should be open and continual communication between the medical command and the transporting vehicle. The key elements of a safe interfacility transfer include communicating the transfer decision; stabilizing and preparing the patient; choosing the appropriate means of transport; determining the degree of monitoring required during transport; and ensuring a smooth patient handover to the receiving facility. While Motient’s Mission Control solution provides essential support for all of these functions, hospitals without a patient transport tool may struggle to manage the logistics of the transfer process on their own.

Why is a standardized infrastructure necessary?

As the pandemic has shown us, patients who spend too much time in the wrong level of care have a ripple effect across healthcare, impacting the number of beds available for high-acuity patients. Ideally, hospitals and other healthcare facilities should be able to access regional patient transport data to give them insight into capacity blockages, available specialty resources, and ongoing needs.

Hospitals that establish an overarching process for how they will handle interfacility transfers will be better equipped to make fast, efficient choices to reduce risks and maintain care quality. By specifying best practices for certain clinical conditions, patient circumstances, and system and staffing constraints, hospitals can conserve limited resources and deliver patients to the best possible care setting.

More and more hospitals are beginning to collaborate with their regional counterparts to develop a better infrastructure for patient movement. For example, larger academic medical centers might agree to receiving patients from urgent care centers and rural hospitals, while smaller hospitals might commit to receiving lower-acuity patients plus a particular subspecialty. When hospitals work together, they can better ensure that all patients receive the care they need without blocking movement within the larger ecosystem.

While regional collaboration was important before COVID-19, it is now essential. Motient’s Mission Control gives hospitals the tools they need to streamline the transfer process. As hospitals refine their own patient movement performance, they will be better equipped to partner with other facilities to establish a regional transfer infrastructure—one that ensures every patient is treated in the best possible location for his or her condition.

To learn more, read this article by Motient co-founder Martin Sellberg, MD, FACEP, How Patient Movement Benefits from Standardized Acuity Scoring in HIT Consultant.

Guest post by Motient co-founder Dr. Richard Watson

Growing up in the rural Midwest, I would never consider myself a “farm boy.” My parents were both PhDs, and although we had cattle and horses, hauled hay, and planted milo, I don’t think we would have qualified to be in the same class as the revered families that know what it’s like to depend on a series of variables that no one has control of to make a livelihood.

Understanding moment-by-moment the importance of coexisting with the land and the weather, respecting what you know and don’t know, and being humbled at every turn either molds character or destroys it. The whole idea seems merciless to me, but some of the most important figures in my life came out of that crucible. I have so many memories of those days, mostly happy, some wonderful, some sad, but many that are hilarious and representative of the chaos that humans, animals, and land can find themselves in.

I would sometimes work for the farmer who lived down the road from us and enjoyed seeing a pro at work and trying to get my head around how someone would choose that life. Harvest was the best in my mind: The moment when all the other moments would come together, and the beauty of the fields gave up their hard worked-for crop. Silage was by far the most mysterious to me. Cutting corn while still green and then blowing it into cylindrical towers where it would be left to ferment and become rich nutrition for livestock. Silos themselves are amazing: These monoliths of the plains are the icons of hard work. They are formidable to withstand the elements and their intended purpose.

The View from Inside a Silo  

I find it interesting that in healthcare, we refer to the silos of care. Certainly, this is true of patient movement. Sending facilities, receiving facilities, and transport services all have formidable foundations, and the infrastructure is an almost impermeable structure that seems limited by its own occupied geography. Standing in a silo, the walls are readily apparent. You become acutely aware of the limitations of your own space. When you do look out, the only view is straight up and is limited to a very small picture of the outside world. That limitation gives minimal data as to what the outside is really like. Healthcare mirrors this in the way we develop space in our own confined geography, but the view out is very limited. Amazingly, you can never see another silo from inside of your silo.

Building Fresh & New on a Strong, Clean Foundation

One of my jobs before harvest would be to clean out the silo. At the beginning of each harvest season, there would be silage leftover from the previous year. I would crawl in through one of the openings and begin shoveling the remains out. At first, it was the sweet fragrance of the fermenting silage, but it would quickly deteriorate into a stinky, wet, rotten mess! Much like health care, there is little interest and getting rid of the old and the rotten.

We continue to keep that covered.

Healthy Harvests — and Systems — Require Regular Maintenance

The future of health care depends on the constant, consistent, calculated dismantling of our silos. We have readily learned that we can’t have a never-ending supply of healthcare resources. We’re only beginning to experience the wave of the aging boomer population and the financial challenges ahead. The decreasing rural population and the regionalization of more and more services will require us to match patients more thoughtfully with medical services. Forming links to telehealth resources will help maintain transport and referral capacity and will be essential. Intentional, proactive communication between sending facilities, receivers, and transporters, will be the first step in understanding the needs and obstacles of the individual institutions. Forming these coalitions and including payers will actually give financial teeth to the decisions made.

The most important realization for health care is that we all have a place in this world. Fears that drive protectionist activity are limited page progress and unnecessarily unhelpful with what we know to be the future.

It is time to shovel out the old and prepare for a new crop.

Guest post by Motient co-founder Dr. Richard Watson

I once had an elderly patient who came to me following complicated heart surgery. She needed a very specialized procedure, and we sent her to a prestigious facility with a renowned medical team. She was from a small, rural farming community, and I wondered how she would react. I asked her what she thought of it all.

“Oh, it was wonderful!” was her response.

“What made it wonderful?” I asked.

“They took such good care of me!” she replied.

I was really glad to hear that, knowing how much effort it took to get her there. I imagine she was impressed by the system, or maybe by the quality of a surgeon. The facility itself had to be impressive.

So, I asked, “What made it so good?”

She said, “Every day in the afternoon, there was this nice woman who would come in and rub my back and talk to me. It was wonderful!.”

Amazing. Literally, hundreds of thousands of dollars had gone into her care. From the early diagnosis to the multiple consultations, to the lab work and the further diagnostics, eventually leading to extensive surgical treatment and rehabilitation. With all of that in the background, the thing that made her care wonderful- high quality in her eyes – was the woman who took the time to rub her back each day and talk to her daily.

And make a human connection.

I wonder who that woman was. Probably not part of the highly trained team whose responsibilities have made them less accessible to the patient. It probably wasn’t even part of this person’s job description. Here’s what it was, was one human being showing compassion for another human being—the essence of high-quality medicine. Human connection is something that can never be replaced or replicated by any technology.

Humanizing the Face of Healthcare  

As we are just now beginning to piece back together our health care system, our understanding of how important the people part of the equation has come forward. The isolation of social distancing, families with their loved ones passing alone, caregivers who are not in any real contact with their patients, a lot of people in healthcare watching their friends and colleagues leave the profession because of the risk and stress, all of which have taken their toll and left us wondering what healthcare will look like now.

The margin in the system as it relates to people has to be addressed. The ability of the hospital environment to expand and contract must be developed and incentivized. Cross-training of staff, training for different staffing levels, stratifying patients more thoughtfully to the varying staffing levels all are needed to maximize the people-to-people interaction during surges. Investing in the education of caregivers and career tracks for nurses that retain our most important part of healthcare is essential.

Creating an environment that allows mandates and excessive workloads to be the norm will disincentivize care teams and career nurses. The mobility of staff continues to be a challenge, but more so for future surges. The balance between pay and commitment must be realized. As salaries catch up, I think this will be less of an issue.

Turning Data into Useful Information & Better Decisions  

All these discussions need to be data-driven. Understanding the current stress on a health ecosystem is essential for making calculated, proactive, and justified decisions about patient care. Data-driven decisions offer a proactive way to identify the moment patient movements are needed to keep the system moving and intact.

People who run facilities need to understand their own capabilities and strengths. Patients need to be matched with the proper resources needed to care for them. Consider the regional need to understand capacity and capability and broadly understand how patients move within the system to utilize appropriate resources fully. The ability to make decisions based on data allows the ecosystem to expand and contract. It gives confidence and expectation to the people doing the hard work of caring for others.

It All Comes to This…

No doubt, each of us will face a moment where we need someone to “rub our back.” It is a constant reminder that simple acts of kindness, even in the midst of the behemoth that health care has become, are what makes our lives rich.

Human beings caring for other human beings—that’s the essence of human connection in healthcare.

Guest post by Motient co-founder Dr. Richard Watson

Olympic legend Shaun White gave his final snowboarding farewell at the 2022 Beijing Olympics. Despite winning no medals this year, the three-time gold medalist leaves a legacy behind. Still, it is evident how much teammates admire him. His casual, calm, and nice-guy approach to the sport and life itself made him a real favorite to follow. It was palpable to watch as White walked among other boarders, many of whom he has heavily influenced. As for White’s next chapter, it seems to include his snowboard and lifestyle apparel company, Whitespace. Even with my very limited marketing understanding, it is not lost on me — a guy named White, who loves snow, and the creative space outside the lines—it’s very clever!

Growing up with pencils and our trusted Big Chief tablet paper and no white space — where the lines went clear to the edge of the paper and so did our writing—that break from regimented, constrained borders is compelling. It brings to mind a book I remember from the 90s, entitled “Margin,” written by Richard Swenson. Margin, to me, has always signified a difference: a margin of victory, a margin of risk, or a profit margin.

Life is Lived Beyond the Lines

But that was not where Swenson was going with the concept. If our lives were a thin sheet of paper, a significant area would be devoted to the responsibilities of work, family, and the cares of the world. Only a margin would represent that part of our lives outside of the regimented. Those areas of creativity, contemplation, and rejuvenation are places where our brains find the most freedom.

How easy it is to “drag and drop” our margins right to the edge, constraining us to that which is within the lines. But isn’t that exactly what health care has become?

While Healthcare is Trapped Inside the Lines

If healthcare ecosystems were a sheet of paper, the incentives have produced a day-to-day behavior with very little outside of the hearing. Lower inventories, single-source supply chains, and conscripted functionality with little or no flexibility for change have all locked us into a box. The system as a whole has become so ingrained with the very concrete processes that disincentivize any freedom to deal with variation.

It’s as if there wouldn’t be a moment outside of the two standard deviations from the mean. The HHS’s Medical Capacity and Capability Handbook is certainly comprehensive if it is nothing else. Layers on layers of oversight and committees, multiple layers of bureaucracy, and micromanagement. The National Stockpile Plan is similar in its comprehensive nature, but at the same time, allows only three days of medical supplies. Not to mention that the lack of replenishment has pilfered every reserve. It is no wonder that the system has been dangerously lean.

We Have a Chance to Reflect, Re-Evaluate, and Rewrite — Outside the Lines

Health care will soon be emerging from the current wave of the pandemic. It will hopefully be a time of reflection and revaluation.

1. Central versus local roles should be examined. With geographic disease variability and seasonal variations taken into account, distinct lines between primary decision and control and that of a supporting function are critical. A one size fits all is insufficient and heavy-handed. Networks for information, supplies, and technology become essential central functions.
   Strengthening the public health system is crucial. To become national healthcare’s real infrastructure and resource, the local public health system has to be the leader in resources, day-to-day monitoring, and system preparation.
2. Incentivizing local and regional supply chain and sourcing. Having these functions locally ensures adequate means that fit the need. Incentives need to be in place to solidify the idea that margin in the system is not waste but is essential to the ability to expand and contract with the need.
3. Bio-surveillance is critical to being in front of these global events. Appropriate recognition of the cost of not embracing vigilance in this area is obvious. In that vein, the FDA has a responsibility for emergent pathways for vaccine and drug development. These need to gain the public trust to assure that pharmaceuticals are available in the appropriate quality and quantity and in a safe manner.

A Healthcare System with Room to Grow  

The lack of white space in healthcare has been glaringly obvious over the last couple of years. The lack of local and regional control has constrained the actual activity of caring for the people around us. As the balance shifts back to the level of care delivery, the system will be free to meet the demands of any challenge.

Guest post by Motient co-founder Dr. Richard Watson

When I was in medical school, I painted houses for work. While my friends seemed to have medically related jobs, I was out on a ladder with a brush in hand, under the scorching heat of Kansas City. The money was good, and I had a wife and two small children to support.

It was good work, but it did have its interesting twists. We’d get a request to paint, and we’d go out to the address, measure, count the windows, look at the trim, and make a bid. One coat, two coats, scraping, pressure washing, repairing all the rough spots, all factors that influence the final dollar. We always added a fudge factor, trying to guess where the issues and labor would go.

Without a doubt, we would be painting the house and come across some issue that needed a repair period, so we would try to remove enough of the problem so that the owner could make a decision about how far they were willing to go to repair. Sometimes they just wanted to “caulk it and paint it,” meaning, ‘we don’t care what’s under there, just cover it up.’ Others would want to open it up and see just how extensive the problem would be. This process is known as “Pandora’s Box.” Some houses, of some vintages, are just massive maintenance money pits. And the more you open, the more you find. It can be a never-ending project!

When Your System Need More Than a Patch Job

There’s a lot of discussion around health care post-pandemic. The system is limping out of this current phase, but everyone seems resigned that these ebbs and flows are the new reality. Our company works in the area of helping facilities understand the movement of patients between facilities and helping in that process.

We’ve come to see how our cobbled-together reimbursement system is not prepared to deal with the changing healthcare landscape. Our per capita healthcare spending has ballooned to almost $13,000, about twice that of the next country. For that big-ticket, we have more hospitalizations for preventable disease, a higher suicide rate, and lower life expectancy. The difficulty in discussing any change in this environment makes the process seem fruitless. The bureaucratic nightmare that is our reimbursement system and our approach to providing private insurance is so complex, that there is no appetite to do any major repair. Instead, just “caulk and paint it”.

How to Open Pandora’s Box — and Transform It

Understandably, if the layers were uncovered, the Pandora’s Box would be unleashed. But make no mistake, to move the needle on this issue isn’t about antibiotic choices or readmission rates, it requires wholesale elimination of current segments of the non-direct patient care expense line. Hardly something bureaucratic systems with a heavy capitalist overlay are in the mood for.

Value-based care seemed to offer some solutions. It just seems that if you don’t change the rules, the bottom line looks the same regardless of who spends the money. Personally, I think this will take a greenfield effort. Go to where the change is happening and use that as an opportunity.

1. We as a country have to embrace health. We can’t make the choices we are making individually without having to be financially responsible for those choices. Our unhealthy population that continually doesn’t bear the burden of those choices is crippling the entire system. We constantly are given examples of other countries with seemingly better healthcare systems only to realize that their population embraces health in a much a different way, than we currently do in the United States. These philosophical changes don’t come easy and most often it is necessary to start early in order to see a real difference.
2. Paying for and delivering healthcare will need to look a lot different in the next 20 years. The tsunami that is the coming healthcare expense line cannot be supported under any reasonable financial basis. Connecting people and resources with the continuum of care model, utilizing targeted interventions, and careful allocation of diagnostic tools and treatments will be imperative. It is hard to believe that introducing new layers of technology to the system will actually make the system more financially sustainable. It seems that every layer of technology just adds a layer of opportunity for those in the business of paying for health care. Resource matching will be necessary at every level.
3. Novel models need to be embraced. The Rural Emergency Hospital is just now being explored. A novel payment method tied to a very specific set of services in the discrete locale might have some chance. But it will only have the chance to be effective if the bureaucracy is not there. The system must be willing to let go of the encumbrances that are dragging it down. The increasing costs of electronic health records, quality metrics, and numerous layers of middle managers and marketing people end up hurting patients and patient care. It’s not hard to argue that in spite of all of the technological changes over the last 20 years, we have done little to advance true patient care and outcomes.

There’s no doubt that we are at a crossroads. The choices that are made in response to the struggle we have come through will be solidified for the foreseeable future. The will and the perseverance to get to the real issues, not just the quick patch and paint, will truly transform health care.

Mission Control is pleased to announce that accessing your data just became easier.

We believe that the insights empowered by the data we collect on your behalf have the potential to reshape the way you think about patient movement. In the past, we have provided this information through a third-party platform that required a separate log-in and password. We’re committed to making our technology as efficient and easy as possible for you, so starting today you can access Mission Control Analytics within the existing application at missioncontroltransfer.com. No new login. No new password to manage. Just an easy “click” on the Insights tab will bring you straight to the content you need.

Once you navigate to the Insights tab, you can choose from the available reports on the left-hand side.

Any time you see data in a table, you still have the ability to “export” to a .xcl file or .csv. This can be an effective way to make comments on past transfers that may need further review.

Additionally, all Medical users will now have access to My Missions, a new interactive dashboard that shows you basic info about the patients you have transferred, like common diagnoses, destinations, and acuity distribution.

Keep in mind, this data is limited to only missions that you have created.

Also newly available is the Facility Info dashboard, where a user can see the contact info, preferred destinations, and preferred vendors. This allows users to reference the information being leveraged by Mission Control Operators to carry out the mission according to your hospital’s set preferences. This information can be easily updated upon request to ensure that we are always executing on your behalf, according to your needs.

For you quality directors, ED directors, directors of nursing, CNOs, and others tasked with leading the organization, you can request access to Transfer Insights, and see rich data across every single transfer entered into Mission Control. This is where the magic starts to happen. What time of day do we tend to transfer Orthopedic patients? How long does it take for a vendor to arrive for time-critical strokes? Where am I sending the most STEMIs and by what mode?

All you need to do is reach out to analtyics@motient.io and we will get you up and running (with demos happily available). Training material is also available under the gear icon inside Mission Control.

At Motient, we are committed to continuing to provide you with the most comprehensive data and the most dynamic analytics that we can provide.

More content is planned for release later this year, so look out for exciting announcements this summer.

Guest post by Motient co-founder Dr. Richard Watson

Recently, our neighbor’s house burned down. Just two weeks ago. Ironically, I woke up early that day to smoke a brisket. As I went out to check the smoker, I heard the popping of wood burning. I looked up to see the faint glow just a block away. I ran up the hill to find six-foot flames at the back of the house.

Thankfully, my neighbor’s family managed to escape. Together they sat safely on the curb in their pajamas as they watched all of their earthly possessions turn to ash. It’s a sight I will never forget.

Few events are as personally devastating as a fire. And on that day, in the early morning, a small light fixture chose to malfunction. And it set off a series of events that pushed the reset button on an entire family.

When I eventually spoke to firefighters, they described it as a “defensive” fire. When they rolled up and saw the house completely engulfed in flames, they quickly assessed that it was already a total loss and moved to protect people and property around the perimeter.

Shedding What’s Not Working in Healthcare

Maybe I’m inclined to see everything as an analogy for COVID-19, but this one seems to be a natural fit. From the beginning of the pandemic, it seemed that our “house of healthcare” was on fire. This conflagration felt like a set-up in many ways. For example, we were already too lean on people—even though healthcare workers are the lifeblood of healthcare itself. Plus, short supply of necessary resources, like medications, equipment, and supplies. Many organizations felt forced into the corner by ever-shrinking reimbursements and expanding layers of expense unrelated to patient care.

All too quickly, health care workers and ecosystems became defensive. That is because we were all just trying to protect the perimeter and do the best we could with the resources we had. In the meantime, the families — those directly affected by the infection — also sat on the curb in disbelief, no different than the family that lost their home in the fire. They have suffered much, and they will never be the same.

Recently, there was a crowd of passersby at the burn site of our neighbor’s home. They comprised of neighbors, people out on their morning runs, or families walking their dogs.

Many pontificated about how the fire might have started. Did trucks get there quickly enough? Why wasn’t our 911 dispatch more effective? Others in the neighborhood slept right through it. Neighbors only a few houses away seemed insulated by the blaring sirens and dangerous flames, blissfully unaware of the unfolding tragedy.

Once again, I draw upon the similarities of our COVID-19 experience. While just a few have been in the midst of the fire, passersby are content to offer advice and point out gaps in the system. Most, especially now, are sleeping through the fire, feeling somewhat secure that the most severe stages are over, and life can go on. All the while, the house smolders on.

Rebuilding the Future of Healthcare

Fast forward a year from now. The charred roof and frame will be long gone. Builders will be on-site with fresh lumber. The sound of hammers and saws will have long replaced the crackling of wood and the breaking of glass. Discussions about carpet and tile, new appliances, moving bathrooms, and enlarging the kitchen will take center stage.

As for healthcare, we will also have a chance to rebuild. Our collective understanding of the people, processes, and resources that are necessary for cost-efficient, high-quality healthcare is stronger than ever.

I wonder, will we take the time to look at the floor plan of what we rebuild? Will we move the walls of reimbursement? And enlarge the communication and networking to connect our previously siloed infrastructure? Or will we slap up some cheap edifice to the old ways of thinking, and bring wheelbarrows filled with charred processes back into the healthcare house?

Anyone who has lost their home will recognize the emotional tug-of-war between rebuilding a site that reflects the previous structure versus starting fresh and rebuilding for the future. There is understandable excitement about returning to the old house we remember. Maybe even with a few upgrades.

At some point, the homeowner might voice a thought about a very meaningful personal item, once situated in a box somewhere in the home. And then their voice trails off with the memory and a sobering realization that this item is forever gone. The heart and soul of our lives are often grounded by memories tied to these material things.

My hope is that healthcare has not lost its heart and soul during these last two years. I choose to believe that the process of dealing with constant unknowns, coupled with loss and grief, hasn’t wrung out the last drop of compassion from those who are driven to take care of people in need.

We have a big job ahead. We can look forward to the chance of stripping away truckloads of bureaucracy that accumulated while we applied bandages to our current system. Together, we must create a new floor plan. We must choose our builder wisely. The lumber must be carefully selected, and we must stand firm: We will not bring the charred processes of the past back into our new healthcare house. The people in healthcare are up for the challenge. Together, we will build it back even better than before.

Guest post by Motient co-founder Dr. Richard Watson

Amid the transition to electronic health records, the rise of the virtual patient, the never-ending push for data gathering at every interface, and a hardware and software explosion, the fax machine lives on. A good friend of mine, who is now the product owner at Motient, first joined the team as we were surveying facilities to assess their patient movement needs. Somewhat new to the environment, he was a quick study; after just a few visits, he made the astute observation that “Healthcare is solely responsible for keeping the fax industry alive!”

As of 2019, approximately 90% of healthcare providers still rely on faxes, a phenomenon that has prompted a recommendation to end all fax usage by 2020. Today, while the percentage of facilities using faxes is elusive, estimates put it at above 75%.

The Rise of EHR

Healthcare as a whole has not been a rapid adopter of the digital revolution. We all remember the MS-DOS green screen that was a mainstay of the nurse’s station while the rest of the world was well into advanced graphics. Yet there are exceptions. As an example of how our inertia can quickly be upended, let’s look at the rise of the electronic health record (EHR) system.

In 2005, a Rand study claimed that EHR systems could potentially save healthcare $77 billion per year through optimized resource utilization, along with providing a seemingly endless list of patient care advantages. Fueled by that study, Congress passed the 2009 American Recovery and Reinvestment Act, which supplied $35 billion to support the “meaningful use” of EHRs, words we have come to know well. With the creative use of reimbursement withholding, adoption came quickly; 13 years later, more than 90% of facilities use EHRs.

Obviously, that much money creates new leaders in the industry. Epic and Cerner took advantage of the moment to move into multi-billion-dollar positions. They became household names, and with the stroke of the legislative pen, an entirely new billion-dollar healthcare expense line was born. As is true of most top-down initiatives, healthcare organizations did not realize the promised results. Costs were higher and savings lower than expected, and the EHR quickly evolved into a very efficient billing machine with little utility as a clinical tool. As EHRs are now loaded with inaccurate data and plagued with inconsistent application, the lack of standardization has become a sinkhole for precious healthcare dollars. EHRs require a constant influx of cash to assure security; review, clean and purge data; and integrate other non-standardized data into the new system of record.

As the two dominant players, Cerner and Epic have chosen two different paths. Epic continues to be insular, with even its own versions not playing well together. The company’s refusal to move toward any data compatibility hampers usability. While Epic Anywhere gives access to others in the club, the company’s protectionist philosophy stymies the industry. As the second most popular EHR, Cerner has scrambled to adapt an interface that is clearly inferior to Epic’s. Cerner’s recent sale to Oracle for $28 billion indicates where this market is headed. Oracle’s public business plan says it will integrate disparate data sources into a cloud-based solution as the company attempts to leapfrog over Epic.

I am dated enough to remember VHS and Betamax. With its name brand, national footprint, and arguably better format, Sony decided not to play with others. As VHS quickly found its way into the market through a wide variety of brands, the format became ubiquitous — not because of its quality, but due to its availability and price point. We’ll see if the analogy plays out.

The evolution of healthcare data also reminds me of how photography has changed. Film, the dominant player, ends up in boxes in an attic with no reference point other than quality, context, and our memories of the captured moment. Any effort to organize one’s pictures required a Herculean effort. Once the digital age struck, those boxes simply moved to file folders collated by date. Fortunately, software can now group them by location, content, and even person. We have programs capable of cleaning up files and reducing redundancy. Video was once 8-millimeter, then Super 8, then digital. All formats created a constant flow of images that ended up in boxes and then files, which were even more challenging to categorize and collate.

Finding the Best Way Forward in the Digital Healthcare Revolution

Healthcare data is following a similar course. While healthcare systems are already struggling with the usability and interconnectedness of their data, here come the wearables: small devices that can harvest an almost endless number of parameters. There are so many companies trying to solve the problem of integration and usability for this endless stream of data that there is almost a festival atmosphere for investment firms. Which are the best short-term and long-term plays? Which company will win the golden prize? In all likelihood, information brokers such as Google and Oracle will develop a platform that will level the playing field. EHR specificity will diminish and become a commodity.

At a more granular level, there are a few realities that should be recognized in the next few years of the digital healthcare revolution:

1. Healthcare billing and clinical data demands need to be separated. While they draw on similar elements, the format of clinical data collection must move away from checking boxes for reimbursement. Macros are now a large part of the current record, which does not represent the true clinical experience; macros are simply a reimbursement multiplier. Cut and paste elements have ballooned medical records to the point of being unusable.
2. Healthcare data needs to be stratified. Categorizing data based on verification, validity, accuracy, and usability is absolutely necessary. The heart rate data from my Garmin watch and the most complex surgical videos are worlds apart; they should be treated as such.
3. The industry needs to be comfortable with not collecting every piece of data possible. Instead, we must be willing to distill the problem down to the necessary elements. Inaccurate and conflicting “data fat” hinders every system; unchecked, it’s a killer.

At this point in the digital healthcare revolution, the deck will soon be reshuffled. Big players will set the rules for the playing field, but the market will ultimately decide what products are most usable. Reimbursement will either hinder the process or propel this reshuffling onward. To find elegant solutions to basic problems that actually require solutions, nimble companies will need to carefully pick and choose which data elements are essential to their function, limiting their scope to solving specific problems. Integrating these precise solutions into our current landscape will help show our industry the way forward.

Sources

1.  90% Healthcare Providers Still Rely on Fax Machines, Posing Privacy Risk. Health IT Security. https://healthitsecurity.com/news/90-healthcare-providers-still-rely-on-fax-machines-posing-privacy-risk
2.  RAND Study Says Computerizing Medical Records Could Save $81 Billion Annually and Improve the Quality of Medical Care. https://www.rand.org/news/press/2005/09/14.html

Rural hospitals face a harsher reality than their urban counterparts.

The U.S. Department of Health and Human Services (HHS) launched the Healthy People initiative in 2010, with the explicit mission to improve the quality of life for all Americans.1 “Rurality” is recognized by the initiative as one of its 14 health disparities because the accessibility of sufficient healthcare for rural residents is significantly less than that compared to people living in more densely populated urban centers.2

And unfortunately, the disparities and inequities of healthcare accessibility for rural residents continue to grow in severity due to the progression of several critical issues rippling throughout the entire healthcare industry. In our new eBook, The Recent Rise of Disparities and Inequities in Rural Healthcare, we examine three of the most recent challenges that hospitals in the country face today. Then we uncover through extensive research how these challenges disproportionately impact rural hospitals.

The three main challenges for hospitals today

Hospital staffing shortages

As reported by HHS, about 16% of all hospitals are experiencing critical staffing shortages.3 However, even before the nationwide spike in healthcare staffing issues, only 11% of all physicians practiced in rural areas. To make matters even worse, 65% of all healthcare professional shortages occur in these same areas.2

Hospital closures

Due to a lack of staff and a limitation of revenue-generating patient services spurred by the COVID-19 pandemic, many hospitals struggle to keep their lights on. Nationwide, there have been an average of 16.4 hospital closures since 2015, resulting in a decline in the number of hospitals from 1,887 to 1,805. Rural hospitals make up an astounding 59% of these closures.4

Response delays and EMS transportation times were already much longer in rural areas than urban ones. Now, as more rural hospitals close, transportation times are increasing — while the likelihood of positive patient outcomes decreases because of delayed access to care.5,6

Worsening socioeconomic factors

People in rural areas tend to be poorer and older than those in urban centers. They live in higher concentrations of poverty, and 18% of them are aged 65 years or older (compared to 13% of the urban population). Rural areas also saw a 0.4% rise in the unemployment rate from 2010 to 1018, while urban areas saw a 4% employment rate growth.6

Based on the preexisting socioeconomic conditions, it’s easy to assume that rural hospitals were already operating on tighter margins than urban ones. In fact, many of them were already operating in negative margins.7 But with rising unemployment and a dwindling population (a 2% decline was observed between 2010 and 20186), more rural hospitals will likely be shuttering in the coming months and years — ultimately resulting in an even greater disparity in healthcare access.

How to overcome disparities and inequalities in rural healthcare

Rural hospitals are tasked with providing positive patient outcomes to an older, sicker, and poorer population than hospitals in urban areas. To do so, these hospitals must contend with staffing shortages, fewer hospitals over greater distances of travel, and worsening socioeconomic conditions.

Download our eBook, The Recent Rise of Disparities and Inequities in Rural Healthcare. You’ll learn more facts and realities behind the challenges that put access to healthcare in rural areas at greater risk — and you’ll find out what can be done to overcome disparities and inequalities in rural healthcare.

Sources

1. HHS announces the nation’s new health promotion and disease prevention agenda. https://www.healthypeople.gov/sites/default/files/DefaultPressRelease_1.pdf.
2. Rural Healthy People 2020. Texas A&M Health Science Center. https://srhrc.tamhsc.edu/docs/rhp2020-volume-1.pdf.
3. Vaccine Mandates Hit Amid Historic Health-Care Staff Shortage. https://www.bloomberg.com/news/articles/2021-10-02/vaccine-mandates-hit-amid-historic-health-care-staff-shortage.
4. U.S. Rural Hospitals Fast Facts. American Hospital Association. https://www.aha.org/system/files/media/file/2021/05/infographic-rural-data-final.pdf.
5. Rural Hospital Closures Maps, 2005 – Present. https://www.shepscenter.unc.edu/programs-projects/rural-health/rural-hospital-closures.
6. Affected Residents Had Reduced Access to Health Care Services. https://www.gao.gov/assets/720/711590.pdf.
7. The Causes of Rural Hospital Problems. https://ruralhospitals.chqpr.org/Problems.html.

Guest post by Motient co-founder Dr. Richard Watson

It would not be surprising to anyone associated with healthcare to state that money drives the motivations and decision-making in the industry. It is certainly noted that the rank-and-file patient care cohort continues to carry the quality torch, but even these voices are filtered through a complex algorithm of “metrics” and “standards.” It has long been noted that the easiest way to control this US healthcare behemoth was through constriction of the dollars and then releasing surplus through carefully gated wickets. And so, as one could imagine, all behavior is now judged against the perceived disruption of revenues.

Now, during the last two years of navigating the rapidly decreasing number of resources, facilities and systems have come to the end of mitigations. The need to move patients creatively in the environment of no hospital capacity and the flexibility needed to make decisions on the fly is not supported in the current CMS reimbursement environment of comply or appeal. Even the easing of constraints does not offer the motivation and direct view to revenues that our health care system requires.

Connecting the Right Resources to the Right Needs

What will it take to comprehensively adapt to a rapidly changing environment? If we approach the answer from the standpoint of what is lacking in the current environment, it would be quickly evident that the system has little ability to match needs with resources. Continuing to push the needs of the patient back to the pinnacle of health care decisions must be the fundamental guiding light for decision-makers. Next, the system should have the ability to assess, categorize and apply the correct resource to the correct need. Standardizing this idea of capability is critical to understanding capacity, which is crucial to the idea of margin in the system. But that is not the whole story. When a new movie hits the streaming services, and suddenly the network is dealing with an isolated surge, the server confirmation flexes to meet demand. The system is decentralized so that multiple resources can be dealing with the traffic, not just a central hub. The math surrounding distributive networking comes into play to shift resources to areas of need. No doubt we are a ways from that dream in healthcare. But we can begin to reward those types of behaviors in the reimbursement process.

Systems that consistently assess the acuity and needs of the patient, track and connect with ecosystem resources using consistent methodology as well as analyze post hoc for trends and outcomes should be rewarded. These small steps are quickly obtainable if the revenue path is clear. We must continue to embrace the idea that matching the right patient with the right resource at the right time is the surest path to the highest quality, cost-efficient care. The technology is there to deal with this environment, and interested groups can see this vision. The question will be if larger facilities and particularly larger health systems can look beyond their own desire for advancement and make the choice to join the ecosystem. I can imagine that the disincentives for that type of protectionist behavior will have to be in place.

We Must Change for the Better, and for Each Other, to Get Where We Need to Be

If there is a lesson we should learn from the last couple of years, it is that we are all in the same sandbox, and we need each other. Citizenship in this privileged industry requires us to care about each other and look beyond self-interest. We no longer have the luxury of a never-ending supply of healthcare, and it will take several years to build back from where this pandemic has taken us. The reimbursement system must change, not only to recognize from where we have come, but those changes must also take us to where we need to be.

Guest post by Motient co-founder Dr. Richard Watson

Recently, I was on several calls concerning the rise of COVID-19 cases and the burden to the health care system. There’s no doubt that there is a point where challenges become crisis — and crisis becomes collapse.

The constant influx of “Breaking News” into our psyche has blunted any ability to decipher the nuances of this escalation.

And, as this is not our first go at this sort of thing, most of the stakeholders have exhausted their list of mitigations. The problems are well known:

• Among the unvaccinated individuals, there is a real percentage that will need hospitalization and intensive care.
• No one vaccinated or unvaccinated has complete immunity.
• Everyone will have an experience with the virus.

Vaccination does not prevent infection, but it will most assuredly keep you from needing hospitalization. The young do well; the older, the obese, and the unhealthy fare less well.

Faster, Harder, More is Not Working. It Never Does.

When I was a doc on the sidelines at the small college football games in the town where I was a family physician, I was fortunate to get to experience quite a few halftime locker room speeches — some effective, some… not so effective. We weren’t a great team, most of the players were there for the academics, not for some higher sporting aspiration. More often than not, we would be behind on the scoreboard as we came in at the half. The guys would be worn and tired, but always competitive.

I remember one particular halftime ended with the plan: “We’re going to run faster, block harder, tackle more, and we’re gonna win this game!” Little consolation for guys who were already giving it all they had — not one player takes to the field to do less.

But I remember one coach, who had the fortune to be on the coaching staff of a Super Bowl championship NFL team. His words went something like this: “They are killing us in the secondary, so we’re going to switch it up. We’re going to a four-man front and blitz more. On offense, we’re going to keep it on the ground even if we don’t score in the third quarter. We’ll draw them in close and then we’re going to open it up in the fourth quarter.”

A real plan — something tangible, thoughtful, and informed. The players knew what they needed to do and there was buy-in that the second half would be different.

Changing the Game Plan Utilizing the Tools We Have

There are few times in the last two years that this global scenario has afforded us the ability to have a tangible, thoughtful, and informed plan. But we know more now than we ever have. We have more tools at our disposal than ever before, and we have people who day in and day out are committed to taking the field — they just need a plan.

Emergency declarations and crisis standards of care are a knot at the end of the rope, a stopgap, a plan of last resort. Essentially, it is telling our caregivers and first responders to run faster, block harder, and tackle more.

We must change the game plan. Here’s how:

• Reimbursement must be changed to allow compensation for the type of patient movements that haven’t had to occur in the system before: longer distances, different destinations, movements up and down the chain more freely.
• We must address agency nursing that allows poaching of staff from one state to another.
• We must use the technology that already exists to improve communication, leverage data, and improve networking at all levels of the system to enhance care in place, match demand with resources and protect quality.

State and federal leaders are constantly looking for new ways to change the COVID-19 landscape. No one likes to deliver the same ineffective byline.

We have the power to do something tangible. We have the information to make concise, effective change.

It’s time to go out and finish the game!

Patient movement pioneer triples headcount while streamlining transportation for critical care patients

TOPEKA, Kan./Jan. 5, 2022 — Motient, a pioneer in patient movement solutions, announced today that its web-based patient movement platform facilitated more than 5,000 patient transfers from 122 hospitals to more than 209 destinations in 2021. Nearly half of these interfacility transfers represented time-critical cases.

Motient’s Mission Control solution streamlines providers’ transport workflow via patient acuity scoring and a comprehensive logistics dashboard. The platform is now averaging an accelerated rate of 20 to 30 patient transfers per day — and, on many days, sees more than 40. Interfacility transfers typically arise when one facility lacks the specialized resources needed to properly care for a patient and play a key role in the delivery of optimal patient care.

Over the course of the year, the Mission Control solution assisted hospitals, health systems, healthcare networks, and other healthcare facilities with a wide variety of patients requiring a higher level of care.  The vendor-agnostic platform worked with more than 132 transport agencies to move patients across 11 states. More than half (52%) of client requests involved ground transport, while 48% of patients were transferred by air.

In 43% of transfers, the referring hospital requested Motient’s assistance to locate an appropriate destination for the patient, particularly as the pandemic exacerbated inpatient acute care capacity constraints. Overall, 17% of transferred patients were identified by the sending facility to require COVID-19 transfer protocols.

Among the company’s key milestones of 2021 was the extension of its partnership with the Kansas Department of Health and Environment (KDHE) and Kansas Department of Emergency Management (KDEM) to facilitate and track emergent interfacility transfers. Under the terms of the agreement, all Kansas hospitals and state correctional facilities will be able to use Mission Control to arrange patient transportation, source destination facilities, and analyze data to improve the patient transfer process.

Internally, Motient tripled its employee headcount and launched a new data analytics department focused on simplifying the consumption and application of patient transport data for clients. The company also evolved its product development process, adopting a responsive, rapid iteration deployment model to reflect customer feedback in real-time.

“Motient is proud to conclude a year of innovation and growth. We value our partnership with the state of Kansas and are deeply appreciative of the response we’ve received from so many EMS agencies and local and private transport vendors,” said Dallan Huff, president of Motient. “In 2022, we look forward to collaborating with forward-thinking healthcare organizations to improve patient outcomes through a more cohesive interfacility transfer process. We are grateful to our key stakeholders for partnering with us to harness the power of patient movement.”

For Coffey County Hospital in Burlington, Kansas, the stress of COVID-19 is all too real. With no ICU unit, the hospital needs to transfer patients to surrounding hospitals — a task that can sometimes take hundreds of calls for a single patient. The difficulty of finding available beds and coordinating patient transfer highlights the need for software for Motient’s Mission Control, which can share the availability of ICU beds in real-time and help arrange the most efficient mode of patient movement. 

To learn more about the struggles rural hospitals like Coffey County Hospital are facing—and how Mission Control can help — read the full article. 

In a recent podcast, Motient co-founder Dr. Richard Watson details how his company’s Mission Control platform is helping rural hospitals improve patient movement — and raising the quality of care and increasing sustainability as a result. 

To learn more about the impact of movement on patient outcomes, read the podcast transcript. 

Data collected from Motient’s Mission Control software highlights the importance of vaccination: The highly contagious delta variant of COVID-19 has infected more than 1,000 Kansans per day for the past 2 months. As a result, the lack of available beds is leading to hard conversations about if (and how) to ration medical care. 

To learn more about what the data from Mission Control shows, read the full article. 

Kansas doctors say they’re seeing more deaths from severe coronavirus infection, with year-over-year mortality rising from 1.8-2% to 2.5-5%. To provide patients with the appropriate level of care and lower this increase in mortality, healthcare providers need tools to locate beds and oversee patient transfers as efficiently as possible, a process that currently takes 12 hours on average.  

To learn how healthcare workers can close that 12-hour window and help patients receive critical care faster, read the full article. 

According to the American Association for the Surgery of Trauma, more than 150,000 deaths are the result of injury each year in the United States. In fact, physical trauma is the number one cause of death for people 45 years old and younger.1 So, what can healthcare providers do to improve outcomes for trauma patients and drive this yearly death rate down, especially in rural areas?

While there are many factors in any given traumatic injury that can ultimately contribute to a patient’s death – for example, the existing heart disease of someone who sustained a severe electrical shock – there are two critical factors that are consistently present in every life-threatening trauma that also plays a role in impacting patient outcome:

• Proximity to an appropriate trauma center
• The efficiency in which a sending hospital initiates, oversees, and completes patient transfer

To better understand how healthcare providers can gain more control over these two factors and help improve the outcomes of their trauma patients, we need to first understand the footprint of American’s Trauma Center Network.

Navigating the Trauma Center network

There’s an expansive network of trauma centers throughout the US, with each center designated as Level I, Level II, Level III, Level IV, or Level V. The criteria that determine a trauma center’s level vary from state to state, but generally a Level I Trauma Center can provide total care for the most critical injuries, while a Level V Trauma Center can offer basic emergency department services and has trauma nurse(s) and physicians available upon a patient’s arrival.2

Rural states, however, tend to have fewer Level I Trauma Centers. Additionally, rural hospitals that are a part of the trauma network are usually more spread out across greater geographic distances than those in urban areas. For example, Montana is the fourth largest state with over 145,000 square miles of land,3 yet it has no designated Level I Trauma Centers. (It does have 4 Level II Trauma Centers and 3 Level III Trauma Centers.)4

So, if an EMS team brings a trauma patient to a Level III Trauma Center in Montana for stabilization, but the hospital determines the patient needs the care of at least a Level II Trauma Center, then there’s little time to waste in coordinating patient transfer.

Fortunately, with a greater insight into which surrounding hospital is most capable of providing the necessary level of care (weighed against geographic distance, patient condition, and other variables), plus the ability to designate the mode of transport and oversee patient movement in an efficient manner, the sending hospital can efficiently and rapidly manage and oversee every aspect of the patient’s transfer to a Level II Trauma Center.

Improving trauma outcomes with Mission Control

With Mission Control, Motient’s SaaS platform, healthcare providers in or out of the Trauma Center network can coordinate the most appropriate and efficient transport possible for stabilized patients.

Sending hospitals in rural areas can use Mission Control to gain real-time insight into the capabilities and capacities of surrounding Trauma Centers. Informed by their own patient assessment and guided by the previously inaccessible data delivered to them via Mission Control, healthcare providers can better ensure that trauma patients receive the appropriate care they need as fast as possible. Mission Control helps them to rapidly determine the receiving hospital most likely to optimize a patient outcome, arrange the appropriate ground or air transport, and coordinate with all stakeholders – from EMS teams to the receiving hospital – seamlessly and in real-time, every step of the way.

Learn more about how Mission Control can help you improve patient outcomes for trauma victims – and let’s work together to bring down the national death rate.

Sources

1. Trauma Facts
2. Trauma Center Levels Explained
3. Size of States
4. Trauma Centers

30% of healthcare workers are considering leaving the profession due to pandemic-related stress. As the Delta variant surges on, we understand trauma for healthcare providers isn’t over, but we are hopeful that technology can make a small impact in lightening the load for our frontline heroes. 

To learn how technology can help alleviate stress for healthcare workers, read the full article. 

Nurses shouldn’t be bogged down by tedious paperwork or endless charting; they should have every opportunity to care for their patients. Fortunately, there are three ways healthcare leadership can embrace technology and get nurses back to the bedside. 

To learn what those three ways are, read the full article.

Newman Regional Health, a Kansas-based critical access hospital, is running at 110% of its pre-COVID-19 inpatient acute care capacity. Open beds in its hospital are becoming more challenging to find. There’s also a growing lack of beds in larger nearby facilities, where patients are routinely sent to receive specialized care. Some patients have to travel up to 10 hours to find the closest hospital with bed availability as a result.

Motient’s Mission Control equips Newman Regional Health with the tools and data to find available beds efficiently and efficiently coordinate every aspect of patient movement.

To learn the impact Mission Control is having for Newman Regional Health, read the full article.

Sepsis poses a significant healthcare challenge, especially in rural areas of the country. If not treated quickly and efficiently, it can result in organ failure, tissue damage, and, ultimately, death. Two hundred and seventy thousand people die from sepsis each year in the United States – approximately one death every 2 minutes.1 So to provide the level of supportive care necessary to treat sepsis and prevent a patient from going into shock or dying, healthcare providers need to:

• Recognize sepsis in a patient as early as possible

• Provide the required level of supportive care

• Rapidly coordinate and transport patients when necessary

The not-so-subtle impact of medical transportation  when treating sepsis

When a patient suffering from sepsis arrives in the ER, the hospital may not have the level of supportive care needed for treatment, depending on the patient’s severity and the hospital’s facilities or equipment. But much like a heart attack or trauma sustained from a life-threatening injury, the speed and level of treatment in the initial hours after a diagnosis are paramount. In other words, how fast healthcare providers can get a sepsis patient access to the treatment they need will undoubtedly impact that patient’s outcome.

And many times, especially in smaller, more rural communities where greater distances separate healthcare facilities, this means arranging the proper medical transport to the right healthcare location as soon as possible. Because for every hour that treatment is delayed, a patient’s risk of death increases by almost 8%.2

Treating sepsis like the medical emergency that it is 

Once a sepsis diagnosis has been determined – whether it’s made by the healthcare team at the hospital or the first responders on location – there’s little time to assess the level of care needed. There’s even less time to figure out where that level of care can be provided and subsequently coordinate the appropriate transport, be it by ambulance, fixed wing, or helicopter. That means decisions are made quickly. And when a decision is made to transfer a patient, then transportation arrangements must be made efficiently and effectively to save precious time.

However, the fastest mode of transportation must also be weighed against the patient’s most urgent needs. Will a certain transport have the necessary equipment? Can transport and the destination hospital be able to accommodate a patient’s comorbidities? These are only some of the factors that must be taken into consideration – all the while, the clock continues to tick.

How to choose clinically justified medical transport for sepsis patients 

We can help healthcare providers save precious time when arranging medical transport for sepsis patients. Mission Control is our SaaS platform that equips providers and nurses with the tools and data necessary for selecting the appropriate medical transport method. The Mission Control team seamlessly and efficiently handle transport logistics, communicates with all stakeholders, and analyzes transport and facility resource utilization. Sepsis patients get to the treatment they need faster — and healthcare providers see improved patient outcomes.

Learn more about how Mission Control can help you improve the patient outcomes for sepsis patients here.

Sources

1. Here’s Why Now Is the Time to Learn About Sepsis.
2. Treatment.

When it comes to sudden cardiac arrest, having immediate access to hospital care more than doubles a patient’s chances of survival.

According to 2019 data, only 11% of all patients in the U.S. who suffer a sudden cardiac arrest outside of a hospital survive. And that’s after being administered emergency medical services.1 Conversely, the median survival rate for those who experience sudden cardiac arrest in a hospital is approximately 25%.2 That’s over a two-fold increase.

The role of EMS response times in surviving sudden cardiac arrest

So, if a patient can’t have immediate access to hospital care or a higher level of care, then the ability to transport that patient to a medical facility as fast as possible becomes paramount. While studies on the correlation between EMS response times in the survival rate of out-of-hospital sudden cardiac arrests are a bit sparse in the U.S., a 2020 study conducted in Sweden highlights the need for efficient patient response and transport. In its findings, the study observed that survival of up to 30 days after a sudden cardiac arrest were notably higher in cases where EMS response times were less than 10 minutes.3

In other words, there’s a straight line between fast EMS response and transport and an increased likelihood of survival for sudden cardiac arrest patients. When someone suffers a cardiac arrest outside of the hospital, the responding EMS will take the patient to the nearest medical care facility. But many times — especially in rural areas — the hospital that’s closest may not be capable of providing the level of care needed. In these situations, the patient will be stabilized—but they’ll still need to be transported to a hospital that can provide the proper care.

So, if healthcare providers hope to drive up the current 11% survival rate of patients who suffer out-of-hospital sudden cardiac arrests, they must make coordinating and overseeing the transport of these patients from one hospital to another as efficient and seamless as possible. But how?

Addressing the logistical setbacks that slow down patient care 

Until you can remove the hurdles that drive up EMS response and transport times, survival rates for patients suffering from sudden cardiac arrests will continue to be negatively impacted. Some of these hurdles include information silos (such as lack of visibility into a receiving hospital’s capacity and capability) and communication silos (lack of real-time coordination and updates across all stakeholders).

And for rural hospitals, geography is another critical hurdle. Hospitals in rural areas are more spread out across counties versus those found in bigger urban centers. Not only are EMS teams and those coordinating patient transport stifled by lack of information and communication, but they’re often tasked with moving patients over long distances.

If you as a healthcare provider want to improve the survival rates of patients suffering from sudden cardiac arrests, then you need to:

• Remove data and communication silos across medical care teams 
• Efficiently assess the patient’s current transfer and medical needs
• Quickly find a destination facility best capable to provide optimal care 
• Coordinate with stakeholders in real-time 
• Apply analytics to further improve patient movement over time

How to improve outcomes for patients suffering from sudden cardiac arrests

At Motient, we’ve developed Mission Control, our SaaS platform to help healthcare providers rapidly coordinate the most appropriate transport possible for patients once they have been stabilized. By using Mission Control to coordinate and manage patient movement between hospitals, healthcare providers can actively work to increase the likelihood of survival after a sudden cardiac arrest.

EMS teams and hospitals can use Mission Control to view patient-movement data in a single place and communicate seamlessly with each other in real-time. For those in charge of coordinating patient movement, Mission Control helps them determine how time-critical a patient’s care is and which hospital (considering on-site equipment, staff expertise, geographic location, and other important variables) is most likely to offer the best possible care.

Mission Control also captures and brings together otherwise inaccessible data on a single analytics platform, providing teams with real-time insights across the entire patient movement process. While never collecting protected health information (PHI), Mission Control still enables the analyses of a patient’s condition, factors such as response times and course of treatment, and outcomes. These analytics are then applied when coordinating patient movement to further help improve patient survival rates.

Learn more about how Mission Control can help you increase the efficiency of patient movement — and improve the survival rates of patients suffering from sudden cardiac arrests.

Sources 

1. Heart Disease and Stroke Statistics—2021 Update
2. Survival After In-Hospital Cardiac Arrest in Critically Ill Patients
3. Shortening Ambulance Response Time Increases Survival in Out‐of‐Hospital Cardiac Arrest

As of September 16, roughly 54% of the US population has been fully vaccinated against COVID-19.1 While that’s encouraging – and the number of vaccinated Americans continues to climb with a 7-day average of 413,000 administered vaccines2 – a myriad of cultural, regional, and economic factors still poses a challenge for COVID patients in need of hospitalization.

So far in September, the country is seeing an average of 145,000 new cases every day.3 Out of those cases, the daily number of COVID patients requiring admission into a hospital averages 93,000.4 And, unfortunately, hospitals everywhere are feeling the strain.

In the first week of September, NPR reported that 59% of all hospitals were under high or extreme stress.5 But what does this mean, exactly? Based on a framework developed by the Institute for Health Metrics and Evaluation (IHME),6 a hospital is operating under high stress when COVID patients occupy 30% or more of its ICU beds. When the number of COVID patients using ICU beds reaches 60%, then the hospital is operating under “extreme stress.”

In Kansas during the month of August, Motient’s patient-movement platform, Mission Control, saw two weeks in a row where hospitals were almost fully at capacity — and the other three weeks were still running much higher than normal.

The federal government released new data that shows a marked decline in the number of hospitals considered either “high” or “extreme stress” when measured against the IHME (Institute for Health Metrics and Evaluation) framework – dropping down to 45% of all hospitals.7

Still, this is nearly half of the hospitals in the United States. And when looking at the government’s most recent data through the lens of states with the smallest to largest populations, a clear takeaway comes into focus: More sparsely populated states with the biggest rural areas are being hit the hardest.

There are 23 states with hospitals that fall into the “high” or “extreme stress” category (Idaho is the only state to reach “extreme stress,” with Covid patients occupying 60% of its ICU beds). Out of those 23 states, 14 of them have populations under 5 million: Wyoming, Alaska, Montana, Hawaii, Idaho, West Virginia, New Mexico, Mississippi, Arkansas, Utah, Oklahoma, Oregon, Kentucky, and Alabama.8

This means that 60% of all hospitals considered to be “stressed” with COVID ICU hospitalizations are in many of our least populated states.7

The Challenge of Patient Transportation in the Time of COVID-19

Hundreds of rural hospitals now teeter on the brink of being overwhelmed by the current numbers of COVID patients in their ICUs. The rural healthcare system is already plagued with staff and resource shortages, which only add another layer of complexity when trying to get a COVID patient – or any patient for that matter – to the hospital most capable of giving the appropriate level of treatment and care.

In rural communities, nurses and other healthcare providers in rural communities need fast insight into which surrounding hospitals have the capacity, treatment capability, and resources necessary to provide immediate and urgent care to a COVID patient. Currently, for many nurses and hospital staffers, the effort of communicating, coordinating, and handling various administrative aspects of patient movement simply takes too much time, too much back and forth across stakeholders, and too much focus that’s better spent elsewhere.

Cut the Time It Takes to Provide COVID Patients the Care They Need

We can help nurses and others in rural communities quickly find a hospital capable of taking and treating their COVID patients – and we can also help them expedite the arrangement of appropriate medical transport. Mission Control, powered by Motient, equips providers with the tools and data necessary for selecting the medical transportation best suited for their COVID patients, including equipment and mode of travel. With Mission Control, networked healthcare providers use an acuity assessment tool to select medical transport. They can also use a single dashboard to seamlessly oversee all transport logistics, communicate with all stakeholders, and analyze transport and facility resource utilization.

As hospitals in rural areas continue to struggle with COVID hospitalizations, the ability to quickly find and arrange transport to a healthcare facility able to take patients is perhaps more pressing now than ever. In August in Kansas, our Communications Team called on average, over sixty facilities per mission (per patient) for two weeks in a row on behalf of care teams. That’s valuable time that care teams were able to spend doing what they do best — providing life-saving care to the patients who need them most, where and when they need them most.

Learn more about how Mission Control, powered by Motient, can add value to your facility — and keep care teams doing what they do best: Providing lifesaving, excellent care.

Sources

1. COVID-19 Vaccinations in the United States.
2. Trends in Number of COVID-19 Vaccinations in the US.
3. Trends in Number of COVID-19 Cases and Deaths in the US Reported to CDC, by State/Territory.
4. Prevalent Hospitalizations of Patients with Confirmed COVID-19, US.
5. Where Are Hospitals Overwhelmed By COVID-19 Patients? Look Up Your State.
6. COVID-19 Results Briefing: the United States of America.
7. COVID-19 Reported Patient Impact and Hospital Capacity by State.
8. US Census Bureau.

Approximately 795,000 people in the United States have a stroke each year.1 But many people who suffer from a stroke don’t live within easy distance of a healthcare facility — not just for emergency purposes, but for preventative measures like doctors’ appointments.

A doctor’s appointment might be a ten-minute drive and an hour or two out of their day in urban areas. However, in rural or frontier areas, a doctor’s visit could be one or more hours each way and at least half a day of missed work. “Rural patients — especially with lower-income jobs — often don’t have the time or financial flexibility to do that.”2

The Complexity of Stroke Diagnosis and Treatment

One way of the complexities in managing stroke is how it is diagnosed on that first presentation. Myocardial Infarction (“MI” or heart attack) can be diagnosed by electrocardiogram (ECG), blood tests, and other non-interventional activity within minutes of being admitted to the emergency department, while those with symptoms of stroke have a quick bedside history and neurologic assessment for the preliminary diagnosis, followed by a computed tomography brain scan to assess what type of stroke may be occurring.

Evidence-based medicine shows that obtaining a patient history (last known time well), completing a standardized functional neurologic assessment via a stroke scale, and getting them to the CT scan as quickly as possible provides the patient a best opportunity for a correct diagnosis and treatment. Timely CT exams, access to radiologists, neurologists, and labs equipped for neurological intervention are key limiters to rural treatment of stroke.

Considering these diagnostic and treatment complexities, time is the greatest challenge in this situation. Every nurse or physician caring for a stroke patient is against the clock once the patient arrives in the ER. Time is brain: “Up to two million brain cells die every minute when oxygen and nutrients are cut off.”2

CT scans are part of the standard of care when diagnosing stroke patients. Even though the CT scan takes just minutes to complete, it then requires a radiologist’s interpretation after sending the images digitally, which can take up to 45 minutes. Once all the data points and tests results are in, a diagnosis of what type of stroke, and what type of intervention is needed, can be made. Adding to that is time spent finding an accepting physician at a hospital, securing emergency medical services (EMS), and preparing the patient for what is next, to transfer to a primary or comprehensive stroke center for further care and evaluation.

Stroke cases don’t happen in rural hospitals every day, so these providers stay sharp and prepared through training and predetermined processes and workflows for time-critical cases like this. In spite of this, a rural facility might receive 10-30 cases per year, but they likely won’t be seen by the same caregivers.

Rural Facilities Cope with Shortages in Resources

The further a patient lives from a healthcare facility, the more time can be lost before accessing care. If staffing is a challenge, there may not be a full-time CT person on staff — one must be called in, adding time to the already fragile “time is brain” window. To add to that, one resource has found it can take over an hour to receive the scan results.2 The time increases can be the difference between recovery and disability.

Another obstacle rural facilities face in stroke cases is that they may not store fibrinolytic, a clot-busting drug that is needed to treat some types of strokes. It’s expensive, and once reconstituted, it expires quickly. Since resources and funds are scarce in rural facilities, it’s not something that can be risked wasting. Research confirms that rural patients with stroke are “less likely to receive intravenous thrombolysis or endovascular therapy and had higher in-hospital mortality than their urban counterparts.”3

Putting a Proactive Plan in Place

Every healthcare practitioner strives to provide the best possible care for their patients. When your patients can be the people you live amongst in rural communities, there is an almost tribal pressure to protect and take care of your own.

When resources aren’t available, it’s necessary to put a plan in place so that the process can begin as seamlessly and quickly as possible. In many frontier areas, transport is the biggest delay. Patient movement systems can help save time and lives [link to Mission Control]. If the patient needs to be transferred — sometimes over 250 miles away or more — it can mean important “brain-time” for the hospital to have a patient movement platform in place that helps the care team align the appropriate destination and transport mode with the patient’s needs.

What Must Happen for Change to Occur

These are all reasons why rural hospitals need to have a stroke champion, standardization of processes, and support from the administration when putting processes in place for sustainability. In one such case, a nurse in rural Kansas decided to champion the case of strokes in her hospital. After completing a review of strokes over several years and viewing the CDC website for stroke mortality, she was determined to move the needle and implement standardized stroke care. She got others in her hospital excited about it, and they worked together to find resources to increase fibrinolytic usage for the appropriate patients and lower the rate of strokes in their county. Dr. Karen E. Joynt Maddox, senior study author of Urban-Rural Inequities in Acute Stroke Care and In-Hospital Mortality, states: “… cardiovascular and other health outcomes are much worse in rural areas… This study shines light on one area where changes in care, such as the introduction of telehealth or other programs, could really make a difference.”4

The gap between geographic and resource limitations in rural communities shouldn’t be a factor in the access or quality of care people receive for strokes. Fundamental changes to processes and facing the existing inequities and disparities in healthcare must occur.

On the frontier, it’s a reality that we can have all the passion in the world, but we need resources. We need plans. We need change.

And we need champions.

If you’re interested in a patient movement solution for your healthcare facility, contact us today.

Sources

1. Stroke. CDC. May 3, 2021.
2. Closing the gap for stroke patients in rural areas. Cliff Mehrtens. December 2, 2020.
3. Urban-Rural Inequities in Acute Stroke Care and In-Hospital Mortality. Gmerice Hammond, Alina A. Luke, Lauren Elson, Amytis Towfighi, Karen E. Joynt Maddox. Stroke. 2020;51:2131–2138.
4. Stroke patients more likely to die in rural hospitals than in urban ones. American Heart Association News. June 18, 2020.
5. Stroke survival rates worse in rural areas, study says. Julia Evangelou Strait. June 18, 2020.

I am excited to let you know about some changes that our team has been working on that represent us combining your feedback with our best efforts to move our organization forward. 

Our company, Cheyenne Mountain Software, will now be known as Motient (pronounced moh-shunt, in case you’re wondering). Mission Control, the product most of you know, will remain the same. I’d love to tell you more about why we’ve made this shift and why we’re excited about it — and why we want you to be, too. 

As part of the change, we have a new name and a new logo, but those elements are only part of what a brand is. Our brand is a promise to you. This promise is to help all of you to harness the power of patient movement. When it comes to moving patients, we want to bring simplicity to what can be, at times, a complicated process. We want to give you tools to help you to be proactive instead of reactive in situations that can turn in an instant. You need data and tools that create sustainability in moving patients and sustainability overall in your organization or system. Our new brand better represents this promise.  

We will continue to empower you with transformational, system-changing solutions so you — as healthcare, data, quality, and medical professionals — can do what you do best.  

In terms of how you work with us today, everything will stay the same, except for our home website and email addresses, which will now come from motient.io. Regarding Mission Control, in particular, you don’t need to change or do anything different. 

To learn more about this change and to help us to stay connected, here are a few things you can do: 

• Visit and bookmark our new website and be on the lookout for exciting updates, like blogs, white papers, and other thought leadership materials 

• Keep an eye out for our new social media pages 

• Add communications from motient.io to your contacts so we don’t go to the dreaded Spam folder 

We’re thrilled to share this journey with you as we embark on this next step, and we are grateful for your continued support. As always, please feel welcome to respond directly to this email or contact us with feedback here. 

What can we accomplish, together, when we harness the power of patient movement? Let’s find out.  

Sincerely, 

Dallan Huff 
President, Motient 

Patient assessment scores exist to stratify patients traditionally by using specific anatomical and physiological indices. An assessment score can help the health care team determine the appropriate triage, aid in decision-making through standardization of clinical findings, and objectively score the severity of the patient’s illness or injury.

A Snapshot of Patient Assessment Scores

Patient assessment scores are used throughout the healthcare continuum from nurse to physician and from outpatient to inpatient. Some scores inform decision-making, such as the Braden Scale, Clinical Institute Withdrawal Assessment for Alcohol-Revised (CIWA-AR), or the Modified Early Warning Score (MEWS). In contrast, others assess the severity of illness or injuries, like the National Institutes of Health Stroke Score (NIHSS), Glasgow Coma Scale (GSC), and Injury Severity Score (ISS).

A Common Language of Sickness

These scores exist as a universal language in medicine: Without having fluency in each other’s mother tongue, a healthcare professional in rural Kansas and urban New Delhi would understand a patient with a GCS of 7 or an ISS of 15.

These internationally recognized patient assessment scores allow healthcare professionals to gauge patients’ clinical conditions and potential needs based on units of physiological data. Others exist to assist in care decision-making within a specific scenario. Still, no current methods exist for identifying and quantifying into a common language the elements of a patient’s condition when hospital transfer is needed.

A Remaining Utility Exists Despite Score Saturation

With this wealth of scoring methodologies, a natural saturation occurs: How many is too many? Scoring system fatigue occurs, and some scores are naturally weeded out according to how much utility they provide. Certain scoring systems become mainstream while others get left behind because there are simply too many, too complex, or used in such rare circumstances that their lack of utility is the cause of their extinction.

However, none of the current scoring methodologies illuminate the unique variables and considerations inherent to adult interfacility transfers. Removing a patient from the resource-rich environment of a hospital setting requires a practical understanding of the level of care necessary during transport to maintain established stability, and the risk of patient deterioration outside the environs of a hospital, along with identifying the severity of illness or injury.

Interfacility Transport: Measuring More Than Miles

One of the current gaps in interfacility patient transport is not having guidance to clinical scoring that assesses the illness and injury severity and risk when taken out of the resource-rich environment of an ED or hospital bed. What is the best type of transport for a patient who needs a neurological intervention 60 miles away versus a non-time critical orthopedic injured patient at the same facility and their receiving hospital is 200 miles away? Before deciding on BLS, ALS, or critical care, air or ground, what questions must be answered?

The Acuity Index: Capturing Severity of Illness, Level of Care Needs, and Risk for Deterioration During Transfer

The lack of a method to objectively quantify the nuances present in adult interfacility patient transfers has created the need for the Acuity Index. The Acuity Index is based on decades of emergency medicine and medical transport experience specific to the context of emergent interfacility patient transfers.

The Acuity Index addresses the question of “how sick is this patient,” which informs the level or urgency in moving the patient to definitive care and the risk of patient deterioration during the transport process by capturing information in three key areas to guide transfer decisions.

1. Level of care that will be needed at the destination facility and time criticality of the working diagnosis

2. Physiological support or intervention that has been instituted to maintain patient stability

3. Common factors that contribute to the risk of deterioration during transfer

The information gathered under these categories stratifies and assigns a numerical value to each patient. The value reflects both the patient’s illness level or severity along with the level of care needed in the transfer process such that the patient maintains or ascends the level of care ladder through this acute phase of their clinical journey.

Creating a Common Language for Interfacility Patient Transfer

The value of the Acuity Index score is specific to patient movement. Other scoring systems can measure patient conditions and influence treatment options for future research, outcome measurement, and reimbursement purposes. The Acuity Index explicitly scores a patient’s condition as appropriate for transport between the sender, EMS services, and the receiver. It has a specific use and value applied directly to patient movement.

The Acuity Index introduces another language for the medical world in a transfer scoring system. However, instead of increasing saturation, the Acuity Index fills a much-needed gap: The Acuity Index asks eight questions, broken into three parts, to determine patient level of care, physiological support, and risk of deterioration. The Acuity Index asks straightforward questions that consider clinical workload, risk, transport, a prognostic perspective of the patient, all critical components of moving the patient between controlled and uncontrolled environments.

*On the Frontier is an ongoing series exploring the realities of rural healthcare. If you would like to contribute or have questions, please contact us.

On the frontier, rural healthcare facilities endure experiences that other healthcare facilities don’t. Some are enjoyable aspects of small-town living, such as knowing your patients as friends and neighbors. But more complicated is living with scarcities in resources.  

There are daily financial, clinical, time, and resource-related realities of being a rural healthcare professional that urban and suburban peers might not consider. A harsh statistic rural residents face? From 1999-2019, rural areas suffered the highest age-adjusted mortality rates (AAMRs). In fact, during this time the disparity in mortality between rural and large metro areas tripled.

Why did this occur? A few reasons are most likely. There are far fewer resources available in rural healthcare facilities. There is generally far less money allocated. When patients need specialty care, the facilities they need to be transferred to are spread further apart.

People, including highly skilled people like doctors and other medical professionals, too often leave rural areas in favor of more densely populated regions. This, of course, means that there are fewer highly skilled people available — and even fewer specialists, such as cardiologists, neurosurgeons, or pediatric specialists. Of course, normal circumstances were further exacerbated by rural hospital closures and the COVID-19 pandemic.

The people who decide to stay on the frontier tend to be incredibly resourceful. They are excellent problem solvers and creative thinkers who aren’t shaken by much — essential qualities for rural healthcare.

Tightknit Communities Create a Unique Connection in Hospital Settings

Rural healthcare workers tend to know their patients not only as patients, as might usually happen in more urban areas but as neighbors — sometimes, even as friends and family. The lab tech isn’t just someone you meet at work; he’s your best friend from third grade. Likewise, your patients aren’t just “the hip repair in room 314” or even “Mr. Jones” — that’s Dave, your cousin.

There’s an intimacy in a small town that cannot be duplicated in an urban center. On the frontier, the people you work with are the people you live with.

Every patient doesn’t just have a name — they have a story. You don’t just know their patient profile; you know their families, where they went to school… You might even know how they take their coffee.

Fighting for Access to Resources

Rural healthcare professionals are aware of the challenges — and benefits — in the care they provide. But, despite ample evidence and rationale to provide better care and allocate more resources to rural areas, many pathways, processes, and access to funding are still difficult for many rural areas in America. As a result, even though 19.3% percent of the US population lives in what is considered a rural area, access to equivalent healthcare may remain elusive for them.

For medical professionals within the system, the fight for resources can feel like an uphill battle. Beyond their daily jobs, they are tasked with solving resource problems with many different people, offices, and bureaucracies.

On the Frontier: With Better Access to Quality Healthcare

Rural hospital facilities’ existence is dependent on champions. A person — or people — who will fight for their hospital, their peers, their patients, and their community. Champions who know the challenges and generate excitement about the possibilities. Tireless against pushing back and tireless in pushing forward. To stop — and, hopefully, reverse — the increasing disparities that rural areas face, people involved in healthcare, including researchers, funders, and policymakers, must better appreciate the factors affecting the rural healthcare system. One step forward is to create sustainable standardization of processes and administrative support. By doing this, positive patient outcomes will increase, and rural healthcare facilities will benefit.

Sources
Cross SH, Califf RM, Warraich HJ. Rural-Urban Disparity in Mortality in the US From 1999 to 2019. JAMA. 2021;325(22):2312–2314. doi:10.1001/jama.2021.5334

A patient assessment score helps health care teams allocate resources and determine the appropriate care a person should receive. Until now, there has been no standardized methodology to determine the vital, transfer-specific elements of a person’s condition as necessary to how they will be moved between facilities, using which modalities and resources.

Founded in Decades of Real-World Expertise

The Acuity Index was created by Martin Sellberg, M.D., FACEP, and contributed to by Richard Watson, M.D. It’s based on their combined decades of emergency medicine and medical transport experience in various emergency departments, from rural and frontier settings to major urban trauma centers.

Drs. Sellberg and Watson recognized a need to assess the unique variables considered during adult interfacility transfers. When a person is removed from the resource-rich environment of a hospital or similar setting, there must be a commonly understood measurement to determine their current and continued stability, the interventions and monitoring skills needed to maintain that stability, and their risk of deterioration once they leave the hospital and begin their journey to definitive care.

The Acuity Index helps answer questions like this: What do providers consider when determining the most appropriate mode of transport for a patient who needs a neurological intervention 90 miles away versus a stable orthopedic injured patient at the same facility when their receiving hospital is 200 miles away?

8 Questions. 3 Key Areas. Invaluable Information.

The Acuity Index asks healthcare professionals to answer eight questions. The questions consider clinical workload, risk, a prognostic perspective of the patient, and in general, the level of care needed based on the severity of illness, all critical components of moving the patient between controlled and uncontrolled environments.

The information gathered under these categories is weighted and assigns a numerical value to the person being assessed. The value reflects the patient’s illness level or severity to help determine the level of care needed in the transfer process, such as crew capability, recommended mode, and other factors — information that was previously not possible to standardize. This Acuity Score stratifies patients into groupings to aid quality departments and enhance reporting processes.

The Acuity Index Creates a Common Language for Interfacility Transfer Assessment

The Acuity Index creates a common language for transfer assessment. Instead of increasing the saturation of assessment scores, however, the Acuity Index fills a critical need: The value of the Acuity Index is specific to patient movement, an assessment that previously did not exist.

The decisions made regarding destination and timing, and mode and level of care, in patient movement have far-reaching effects on financial and clinical outcomes. Healthcare cannot afford transport decision-making based on random or incomplete information, and the strategy, “this is the way we’ve always done it,” makes little business sense. Instead, interfacility transport should be guided by an organized assessment and decision process and data that can be shared through the system to assist in further dialogue to identify and solve local challenges collaboratively. The Acuity Index explicitly scores a person’s condition as appropriate for critical transport points between the sender, EMS, and the receiver. It has a specific use and value applied directly to patient movement.

The Acuity Index also creates significant value in enabling patient stratification for transfer reporting and quality metrics. The Acuity Score enables quality managers to evaluate resource utilization across patient types, DRGs, and Acuity Scores. Furthermore, the Acuity Score can be used for reimbursement justification and Time Critical Diagnosis assessment and reporting.

Please contact us here to learn more about the Acuity Index and Mission Control.

Mission Control is excited to announce a new interface for mission creation that will further simplify the way you create transfers in Mission Control. The new look provides:

Improved design and fewer overall clicks.

A progress bar to show how far along the process you are.

Map view for selecting your preferred destination options or a picklist option.

If assistance is needed in locating a destination, there is a new method for providing additional information.

You also have the ability to edit data from the destination selection screen without restarting the workflow.

A Mission Summary screen that allows for a selection of a “preferred mode” selection to indicate a desired mode of transport. Users can review all Mission information from this summary prior to submission.

These changes were made improve the overall workflow and save you — and the patients you help care for — valuable time. We hope these changes make using Mission Control more efficient and user-friendly.

The new designs will be “live” on MissionControlTransfer.com starting Tuesday 6/15. We’ve updated our training materials for you to familiarize yourself with the new Mission Interface prior to deployment on the 15th.

Training materials on the new designs are available under “Courses” from the gear icon inside Mission Control. They can also be accessed directly by this link.

We have a number of new features and functionality in the works that we are excited to share in the weeks ahead. Please let us know if there are items that improve the utility of Mission Control for you and your patients.

Questions or Comments? Contact Us.

*disclaimer: Mission Control’s blog is not intended to provide medical advice. Please speak with a doctor or other healthcare professional before beginning, changing, or otherwise altering your healthcare plan.

Stroke is the fifth leading cause of death in the U.S., killing almost 130,000 Americans every year. It’s also a leading cause of severe disability. The National Stroke Association, and others in the healthcare field, devote the month of May to learn how to prevent strokes, increase the awareness of stroke symptoms, and how and when to seek care. May was formally deemed Stroke Awareness Month in 1989 by President George H.W. Bush.

One reason stroke can be disabling — and deadly — is because any time lost during a stroke means valuable care time is lost for the patient: Time is brain. The faster the healthcare team can diagnose the patient and get them to the right facility and with the right specialists, the better their chance at a positive outcome may be. Our case study, based on a fictional example, demonstrates how using Mission Control as a patient movement resource can make a critical difference when a patient with stroke enters your facility.

Case Study: Patient Movement Resource Makes the Difference in Time-Critical Stroke Cases

The Setting

It is a busy night in the 5-bed Emergency Department (ED). The ED Providers on hand are a Registered Nurse (RN) and an Advanced Practiced Registered Nurse (APRN), managing the workload like a well-oiled machine.

The night seems normal. A little past midnight a patient is discharged back to their nursing home. The other patients are stable.

The phone rings.

The Situation

Emergency Services (EMS) is on the line with a possible stroke patient on their way with an ETA of 15 minutes.

Patient Stats 58-year-old male Vitals 190/100 Heart rate 1150-130 BPM Positive stroke score*, including slurred speech and right-sided arm drift Blood sugar 130 Weight 280 lbs. *The Cincinnati Prehospital Stroke Scale evaluates symptoms of facial droop, arm drift, and abnormal speech. If one of those signs is abnormal, there is over a 70% chance the patient suffers from a stroke.

Patient History

EMS informs you that the patient is being treated for a thyroid disorder, hypertension, and hypercholesterolemia. He smokes 2 packs per day of cigarettes and is a truck driver. Home medications include thyroxine, atenolol, and statin (for low thyroid, high blood pressure, and high cholesterol).

What We Know

Patient Profile:This patient is at elevated risk for a stroke due to past medical history, being a cigarette smoker, overweight, sedentary lifestyle, and the findings of his 12-lead ECG shows the patient has intermittent atrial fibrillation with rapid ventricular response (heart in an abnormal rhythm and accelerated rate).

Next Steps

The APRN is assessing the patient. While you are drawing blood for the lab work-up, the CT technician calls and is ready for the patient. You notice other patients’ call lights on and hear on the scanner there is a two-vehicle motor vehicle accident (MVA) on Highway 36.

Priority-setting and critical thinking will be a must to get through the next several hours.

Possible Outcome — Without Mission Control

A few years ago, this situation would have felt chaotic. Stroke patients require time-intensive testing and monitoring that can keep a nurse and provider at the bedside for extended periods of time. The stroke patient’s speech is slowed, slurred, and at times garbled, so additional time is required to perform an appropriate assessment while providing compassionate care during a time-sensitive diagnosis. At the same time, we know “time is brain”, and getting the patient to and from the CT, labs drawn, NIHSS completed, takes time; all with the uncertainty of whether the patient’s condition will remain as is or decline.

Additionally, there are the needs of other patients in the ED. The nurse would be on the phone with the hospital’s transfer center to start the process of getting a neurologist to call the APRN. Furthermore, once an accepting physician was confirmed, there were more orders to give the patient a lytic (clot-dissolving) and blood pressure IV medication. The nurse is preparing the dosing of the lytic while on the phone with dispatch requesting air transport.

Multi-tasking is key, but distractions during lytic preparation is an unsafe practice.

Outcome — With Mission Control

Using Mission Control, the patient has multiple communication specialists working on his behalf, assisting with contacting and confirming the requested receiving hospital and securing appropriate transport for the patient while the nurse and APRN can for care him and the other patients. Knowing the MVA patients could arrive at any time, the care team needs to stay focused on patient care and getting patients transferred out of the ED appropriately. Mission Control staff will comment in the chatbox or call with any updates.

The patient NIHSS is 8 (stroke scale assessment) and the radiologist calls to tell the APRN the CT is clear. You know intravenous alteplase (the clot-dissolving medication) will be your next order from the APRN. The inclusion/exclusion checklist was completed, and you continue to work through the priorities of patient care in the ED. Mission Control connects the APRN and a potential receiving neurologist to discuss transferring the patient for advanced neurological services that are not provided at their hospital.

The patient was accepted by the neurologist, and it was decided by the providers to fly the patient, if possible, as they will assess him for a large vessel occlusion (the type of stroke present in this patient).

Mission Control was there to assist with getting transport arranged for this patient. As the flight crew is in the air, they started administering the clot-busting medication alteplase. We know that time is brain and getting this patient back to his family starts here with us.

Since the local EMS is out on the MVA, Mission Control arranged for another EMS agency to assist in picking up the crew at the airport. Finishing up on the transfer paperwork, the helicopter crew arrives and takes over care of the patient. Just in time, as local EMS calls to give report on the two code red patients they are bringing to the ER.

Thankfully, this hospital can handle these situations successfully thanks to the training and skill of the nursing staff and support from Mission Control.

Mission Control is a valuable resource. It assists in getting the appropriate resources for patients while allowing the staff to utilize their skills and training to stay focused on the patients.

In cases of stroke, time is brain. Mission Control helps ensure healthcare providers, EMS, and patients get access to the resources they need, when they need — when every second matters.

To learn more about Mission Control, click here.

Sources

Centers for Disease Control and Prevention https://www.cdc.gov/stroke/facts.htm

MAY is Stroke Month https://newsroom.heart.org/events/may-is-stroke-month

May is National Stroke Awareness Month: Learn the Signs https://www.columbianeurosurgery.org/news/may-national-stroke-awareness-month-learn-signs-lessen-effects/

May is National Stroke Awareness Month https://www.sophe.org/focus-areas/chronic-diseases/partnering-4-health/may-national-stroke-awareness-month/

Preventing Another Stroke https://www.stroke.org/en/life-after-stroke/preventing-another-stroke

We’ve all heard the sirens blare through our neighborhoods, cities, and while we’re driving to work or school. It’s the universal sound that tells us someone needs medical attention. While we peer outside our window or pull over to the side to let an emergency vehicle pass, we hold a moment of silence in our minds, hoping no one is seriously sick or injured.

This is EMS: Caring for Our Communities

The people on the frontlines of emergency services are EMS professionals, and from May 16-21, 2021, we pay particular honor to them. The American College of Emergency Physicians (ACEP), in partnership with the National Association of Emergency Medical Technicians (NAEMT), has declared the theme for EMS Week 2021 as This is EMS: Caring for Our Communities.

During EMS week, communities and individuals are asked to honor EMS professionals for their dedication and service to their communities which, like so many healthcare professionals, has been tested as never before during COVID-19. Our local EMS are the lifeline to get sick and injured patients to a hospital or higher level of care. Many EMS personnel also have additional job duties, such as fighting and investigating fires, being on standby during sporting events, or being engaged in county emergency management exercises. During COVID-19, it’s become clearer than ever before how critical they are in our communities.

The Real-Life Impacts of a Vital Community Role

While many people work as EMS full-time, many regions in the United States rely on volunteers. Your EMS professional could be your local banker, grocer, mechanic — anyone in the community, though a common trait among EMS personnel is the strong purpose of serving their community.

In this true story, we recount the impact a rural EMT had on his community. “Dan’s” quick thinking and actions saved a school — and a community — from tragedy.

“It was a spring morning, and the K-12 school third block bell had just rung. As students settled into their seats, the fire alarm went off. As students exited their classrooms, there was Dan, a farm mechanic — and local EMT — standing at the front doors, instructing all of us to go out the South exits. Before we could ask questions, buses and cars began to line up and take us out of town. Dan had witnessed a pick-up truck hauling anhydrous ammonia, a common chemical used to fertilize the cornfields of this region, struck by another pick-up truck. If inhaled, the gas can cause chest pain, wheezing, and death in poorly ventilated areas. Due to the accident, the deadly gas was being released into the air just yards away from the school. His actions prevented what would have been a horrible tragedy.”

Dan’s actions are just one of the millions of times an EMT’s quick thinking and actions have led to positive outcomes for our communities.

Thank You, EMS Professionals

EMS provides essential support to our communities, and here at Mission Control, we want to share our appreciation and gratitude to those who continue to serve with their courage, knowledge, and passion. You can thank your local EMS personnel by sending them letters of gratitude, thank them personally when you see them in your community, and always safely pull your vehicle to the right side when they have their lights and sirens on.

Sources
https://www.emsstrong.org/

A year into the COVID-19 pandemic, there is growing confidence we can return to normal activities like travel and vacations we enjoyed before 2020. With the excitement of hitting the open road, there is also reason to pause to ensure we play our part in keeping the roads safer for all this summer. As we venture back out into the world, we’re focusing this month’s theme on trauma in motor vehicle accidents (MVA) as a refresher for all of us to remember how to travel safely.

Stay Alert. Stay Alive.

The American Trauma Society (ATS) and The Society of Trauma Nurses (STI) have collaborated to bring trauma awareness to the public. May is Trauma Awareness Month, which brings an opportunity to share preventative measures of leading causes of MVAs. Each day at least 90 people die in motor vehicle accidents. The significant risk factors in causing fatal MVA accidents are:

• Speeding
• Distracted driving (texting, fiddling with a radio, etc.)
• Driving under the influence
• Not wearing seatbelts

How to Prevent Traumatic Motor Vehicle Accidents

As you travel with your family and friends this summer, these are some ways you can decrease your chance of being injured or killed in a motor vehicle-related accident:

• Ensure the driver of the car is well-rested, without distractions, and not under the influence of alcohol or drugs
• Everyone in the vehicle should be properly secured with a seat belt or age-appropriate car seat
• Ensure the driver adheres to speed limits and adjusts their speed to weather and road conditions

What to Do if You Witness or You’re in a Motor Vehicle Accident

If you are in or witness an accident, please call 911 immediately. Minutes matter, and getting the patient into the healthcare system will help to decrease disability and mortality of trauma patients. Whether you are driving in rural or urban areas, many EMS and hospital emergency rooms have trauma protocols in place to give you the best care available. The protocols assist with getting the injured patients stabilized and to the right level of care the first time.

Every minute counts. Mission Control is here to assist the emergency rooms in locating the appropriate resources, available specialists, EMS agencies, and any other necessary means required to transfer the patient so that the healthcare team can focus on caring for the needs of the patient.

Obviously, not all traumas occur on the roads. Read more by clicking the link below for other resources provided by the ATS and STI. Want to learn more about trauma reporting and Mission Control? Contact us to request a demo.

From everyone at Mission Control, we wish you a fun — and SAFE — summer!

Sources and Resources

Check out the ATV Safety Institute’s Readiness Checklist to see if your child is ready to drive an ATV. https://atvsafety.org/are-they-ready/

Fascinating facts about workplace injuries here https://injuryfacts.nsc.org/

Dog bites pose a serious health risk, with more than 4.5 million people being bitten by dogs each year in the U.S. At least half of those bitten are children. Here are resources on ways to prevent a dog bite: https://www.avma.org/resources-tools/pet-owners/dog-bite-prevention

Whether it’s a trip to the beach or a dip in the community or backyard pool, these swimming safety tips can help you have fun in the sun. https://www.safekids.org/poolsafety

American Trauma Society https://www.amtrauma.org/page/NTAM2021SC

Centers of Disease Control and Prevention https://www.cdc.gov/vitalsigns/motor-vehicle-safety/index.html

Kansas Department of Health and Environment http://www.kstrauma.org/

It’s been over a year since we first heard of COVID-19 and it began to impact not only our healthcare system but the lives of every person on the planet. At Mission Control, we’re looking back on the last year with empathy for those who have suffered, gratitude for those who have served as healthcare heroes and essential workers, and hope for a healthy future — for all of us.

At Mission Control, our goal throughout COVID-19 — and beyond — is to empower healthcare professionals and facilities with efficient, sustainable, and safe methods of patient movement. Our infographic demonstrates some of the ways in which Mission Control has helped hospitals in Kansas with COVID-19 during the past year.

Nurses are a vital part of our care community and, at Mission Control, we value and appreciate their impact every day. From Thursday, May 6, through Wednesday, May 12, 2021, our country takes a dedicated week of the year to pay them particular honor for Nurse’s Week, commencing with Florence Nightingale’s birthday on May 12.

The Backbone of Our Care Communities

Nurses have always worked tirelessly to provide care. During the COVID-19 pandemic, it was clearer than ever the depth of sacrifices nurses make for their patients on the frontlines of healthcare. Nurses not only provide necessary care, but they also have significant impacts on patients’ overall well-being, experiences, and outcomes. Nurse’s Week offers an opportunity for us to honor nurses for the work they do.  

You can honor the nurses in your life, whether they are family, friends, or the nurses who have cared for you, by thanking them with a note, a video, or a thoughtful gift sent to their workplace that they can share with their coworkers.  

From everyone at Mission Control, we send immense gratitude to the incredible nurses in our communities.  

Sources
Celebrating Nurses’ Week
https://www.incrediblehealth.com/blog/celebrating-nurses-week/

Study: 186% Pandemic Spike in Nurse Demand Worsens Turnover and Stress
https://www.incrediblehealth.com/blog/study-covid-19-anniversary-nurse-impact/

Mission Control was honored to be featured in BOSS magazine. Please read the article to learn more about the founders of Mission Control, why they’re passionate about patient movement, and how they are transforming emergency medical transportation.

In 2020, we witnessed the Covid-19 pandemic push the United States’ healthcare system to its limit — and beyond. Along with the dedication, expertise, and commendable perseverance of our healthcare professionals, it became clear that a unified management method of coordination, visibility, and insight into the available resources was necessary to take on the health crisis at hand.

A Centralized Resource to Assist Healthcare Professionals

In Kansas, staffed bed availability reached a critical level (especially COVID-19 beds), as it did in many places around the country —and the world. The system as a whole was strained beyond capacity. Visibility into the existing systems and processes throughout the state was insufficient.

Time was critical. Not only was a centralized system necessary, but the visibility, resources, and efficiency it would provide were vital to support the staff working on the frontlines.

Allocating and Managing the Resources Available

Mission Control is a software program that benchmarks a patient’s acuity and streamlines the care team’s decisions on destination and transport methodology. Based on proven success with the Care Collaborative under the University of Kansas Health System, Mission Control links sending facilities, receiving facilities, and local and regional emergency services providers to coordinate and organize the movement of patients through a healthcare system.

During the early stages of the Covid-19 pandemic, Mission Control demonstrated early indications of “hot spots” by identifying surges of transfers in other parts of the system — surges that, if sustained, had the potential to overwhelm the receiving facilities.

Receiving hospitals became saturated caring for patients during this surge, resulting in difficulty for sending hospitals in placement of the patients they needed to transfer. Seeing this issue as it evolved and in real-time, Mission Control added facility-capacity tracking and bed-sourcing services to its existing platform. The network and capabilities were expanded to include additional regional facilities, creating a better and broader picture of receiving resources and capacity. At the peak of the surge, Mission Control assisted in the movement of patients to and from Kansas resources and facilities in five neighboring states. The Kansas Department of Health and Environment requested Mission Control be made available to every hospital in the state.

One Year Later

Under the contract with the Kansas Department of Health and Environment, Mission Control has been working with the nurses, physicians, and other vital medical staff as a support tool and resource for 100 days as of February 26, 2021, and with the state since mid-2019. Mission Control’s support will continue throughout and beyond the Covid-19 pandemic with access to services, support, and data to enable patients’ efficient and sustainable movement throughout the healthcare system.

Together, we are all committed to the sustainability of rural healthcare, EMS services, and patient transfers’ vital role in all Kansans’ daily lives. We are all indebted to the partners and co-laborers across the healthcare system that have dedicated themselves to patients’ care before, during, and after the surge of Covid-19.

We’re not out of the woods yet. But thanks to our dedicated healthcare professionals at all levels of the healthcare system, we’re making progress.

Mission Control is honored to serve the healthcare system of Kansas and beyond by continuing to aid in the efficient interfacility movement of all patients.

From the latest news and feature updates at Mission Control to trending news in healthcare, patient movement, emergency medicine, and more, follow our blog.

 You’ll be the first to learn what’s new at Mission Control, what our healthcare professionals think about important issues impacting the healthcare industry, and discover tools and ideas intended to empower you as a healthcare provider.

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If you have questions about Mission Control, you can contact us here.