The November Board Meeting was a Webex Virtual meeting arranged by the hospitals IT staff.
Opening
1. The Agenda was modified to include a closed session. Then the Consent Agenda was approved. The Consent Agenda included Minutes from the October Board Meeting; Minutes from a Budget and Finance Committee Meeting; Minutes from a Governance and Planning Committee Meeting; and the Annual Review of Patient Care Minimum and Professional Liability Coverage Resolution, and the 2021 NH&C Board Meeting Schedule.
Reports
1. Hospital Chief of Staff Report—Tom Holt. The community is experiencing a growth in COVID cases. Applications for membership and privileges were passed.
Presentation/Discussion/Action Items
Electronic Health Records (EHR)—Vern Lougheed. The discussion on replacing the EHR system dates back to 2016. Since then NH&C has looked at various providers including Meditec, Epic, Epic-Allina, Epic-OMC, and Epic-Stanford. There was a strong attraction to the Epic system as both Mayo and Allina use Epic, but Epic doesn’t deal directly with small hospitals, so NH&C investigated affiliated providers such as Allina. The costs and contracting agreements with affiliated providers turned out to be problematic. Recently, Meditec has come out with a new service—Expanse Maas. Expanse is a service provided by Meditec and hosted by Google. There is a one-time low cost to joining the service, no long-term contract, and Meditec handles backup, data retrieval, and cyber security. Some of the shortcomings with Expanse are that it doesn’t support virtual care and it can be challenging to incorporate new 3rd party provider software. Still, the IT staff felt that Expanse was the best option available at this time and the best value available. It leaves NH&C “in control of its EHR destiny”. The various cost estimates are: Implementation = $1.5 million; Annual cost = $1.8 million; 5-year cost = $11.4 million. No bandwidth problems are expected and other adopters have had a good experience with Expanse. Not all data stored in the current system will be transferred, but delayed data retrieval will be available. It was stressed that it is important to have a “physician champion,” (and perhaps a nurse champion too) to work with physicians (and nurses) on adapting to the new system. The costs quoted include assigning a Project Manager at NH&C. Given the significance and cost of the project no vote will come until after the Board has had time to study the proposal. If approved soon, the Expanse system could go live in early 2022. The Board thanked Vern and the IT staff for their work on this important project.
Executive and Committee Reports
1. CEO Report—Steve Underdahl. a) COVID: cases are growing exponentially in MN. The 7-day moving average for positive tests at NH&C has risen from 3% in Sept. to 16% now. About 1/3 to ½ of the inpatients in the hospital are COVID related. Staff vacancies are averaging 40 to 50 employees per day. Three staff members and one resident in the LTCC have tested positive and visiting restrictions are again in place. Video visits are encouraged. Testing capacity at NH&C is growing, but staffing is getting more difficult. Underdahl expressed concern for the long term stress and fatigue experienced by staff and providers, and said the administration was seeking ideas on how to best support team members and their families. The news on COVID vaccines is promising. b) Strategic/Operations. Following the Board’s recent retreat, a new 3-year plan is being drafted. The clinics are busy but hospital activity is up and down. The wound-healing project is on schedule and should open in March 2020.
2. Financial Report—Scott Edin. Most service levels are still under budget. No COVID grants were received during the month. YTD the CARES grants have totaled $10.8 million. NH&C is self-insured for health care and benefits/costs have been significantly under budget. An accounting adjustment was made to reflect the lower cost of the self- insurance program: expenditures were reduced by $359,000. NH&C has spent $140,000 on COVID testing through the Mayo Clinic, including currier services. The Mayo cost/test is $78, and patients with insurance are billed. The Net Operating Surplus was $313,000 in Oct. , but there was a non-operating/investment loss on NH&C’s portfolio of $472,000. Including the CARES grant revenue, year-to-date, NH&C has a surplus of $5.9 million.
3. Committee Reports
a) Community Relations Committee—CC Linstroth. The Committee received 13 grant requests from non-profits in the service area totaling $120,000. The Committee’s grant recommendations will be brought to the Dec. Board meeting.
b) Budget and Finance Committee—Fred Rogers. The Committee met to consider a recommendation in an “alternative” investment that offers lower volatility, but less liquidity. The Investment Policy Statement allows up to 10% of the portfolio to be invested in “alternatives.” The Committee approved an investment of $2.5 million dollars to be phased in over 2.5 years.
c) Governance and Planning Committee—Steve O’Neill. The Committee used a consultant to assist in the annual evaluation of CEO, Steve Underdahl. The process received input from staff, Board members, physicians, and other administrators. No formal report or recommendation was issued at this time, but the consultant reported that, “Steve performed exceptionally well.”
Announcements
The meeting stopped for a break about 6:50 p.m. and was followed by a closed meeting.
Next meeting: Dec. 17, 2020.
