Winona Health has been serving the community for 113 years, boasts impressively efficient information systems and is at the forefront of the US healthcare revolution
By Ben O'Hanlon
Winona Health is a non-profit organization, offering care services to the town of Winona, Minnesota. Its history reaches back as far as 1894, when local residents raised money to establish an 18-bed general hospital. Since then, investment has seen many additions; assets now include a 99-bed hospital, a 154-bed nursing home, three assisted living facilities, clinics, a pharmacy and a host of related healthcare services.
The Full Package
Today, Winona is still community-owned, run by a voluntary board of directors and independent of the large healthcare systems. It is operated at primary care level, which excludes staff from performing serious operations such as heart surgery or running a burns unit. However, its portfolio of services does include providing emergency care, nutrition education, rehabilitation and a sleep lab. Winona also works in partnership with two other hospitals nearby in order to offer a complete service to residents.
And if the local community wants evidence that its health service is performing, they need only look as far as the overcrowded awards cabinet. Some of 2007’s most notable achievements include being honored as one of the ‘Most Innovative Acute Care Hospitals’ in the country (according to FierceHealthcare), receiving the Minnesota Quality Award and the award for Health Care’s Most Wired Small & Rural Hospitals, relating to the use of technology (an accolade that has been bestowed for the past six years running).
A Changing World
President and CEO Rachelle Schultz joined the organization five and a half years ago from Banner Health System, a multi-state healthcare provider. Rachelle has nearly twenty years experience in the field of healthcare, ranging from homecare to community-based care, from clinics to hospitals. The way that care is provided, she says, has changed dramatically over that time, with more consumer engagement and greater use of evidence-based practices: “There’s more variation in the types of services that are available and how they’re delivered. Healthcare is more complex today. We have a lot more knowledge and resources available – the challenge is how to use all of the information effectively.”
Efficiency through Technology
Perhaps it is technological advances, though, that have had the biggest impact. If so then Winona has certainly had its slice of the action. The organization works on the philosophy of ‘if it can be automated, it should be automated’. In particular, all medical records are held electronically on what is essentially a single community database. All service providers use the same system, helping them to remain fully integrated. Storing information in this way has ensured that it is always accessible and frees time for staff to spend with patients.
The system, which took several years to develop, also includes a process of issuing alerts to initiate action, designed to help physicians to be more efficient. It’s managed by an internal and external support team who ensure that it is constantly evolving to incorporate new functions. “It’s a very dynamic system; it’s totally integrated into what we do”, explains Rachelle. “We demonstrate it to other healthcare organizations a lot. All things considered we’re a fairly small community hospital and we’re operating an effective, integrated healthcare system, so it can be done.”
However, it’s also the organization’s outward-facing efforts to use technology that sets it apart from its peers. Winona’s online services allow patients to securely access their medical records and, where appropriate, to receive advice via an ‘e-health’ visit. This even enables them to be issued with a prescription at the click of a button.
The online system also includes modules to provide advice and support to help people manage diseases such as diabetes and asthma. Clearly Winona’s community-based approach hasn’t starved it of ambition; the organization is continually striving towards its vision, to ‘be a recognized leader in the revolutionary transformation of community healthcare.’
Planning Ahead
For all the changes in healthcare provision to date, Rachelle is clear that the age of revolution is far from over. Aside from the desire for consumers to take a more interactive approach to their health services, a smaller workforce and increased pressure on resources will require yet more fundamental changes to be made. “As a consumer everyone is going to be put into a position by default where we have to be more responsible for our care and be more knowledgeable about preventative healthcare. That way we’ll have much better access to physicians when we really need them”, she says.
This could involve re-designing the delivery of healthcare with more web-based services or ‘minute clinics’ where patients’ time with the health professional is limited.
The premise could see a dramatic change in the national healthcare system; and Rachelle is busy preparing Winona for the shift: “We need to begin that education process and make sure that people are well equipped, that they have the necessary tools and resources available to them. They need to have really good information upon which to make decisions. We’re also focused on automating processes wherever possible to make sure that time spent with patients is more productive”
People Focus
Alongside its efforts to lead the way in adapting, Winona is keen to retain as much of its 1,000 strong workforce as possible and to ensure that they, too, are equipped with the necessary skills and competencies for a new environment. The organization is aware that this might involve learning how to utilize staff in different ways or to teach them new ways of working.
Whatever the future holds for the US healthcare system, Winona Health seems certain to be driving the innovation process: “I think we’re going to go through a huge transformation over the next five years or so”, Rachelle summarizes. “We have a couple of years to get this re-design in place; if we use technology right, if we think very differently to how we think right now then there’s great potential. These are pretty exciting times.”