In this month’s At the Helm, our Senior Vice President Allen Peckham sat down with Mike Lauf, CEO of Cape Cod Hospital and President and CEO of Cape Cod Healthcare, a regional health system with more than 450 physicians and 5,300 employees. Allen and Mike discussed how the pandemic has led to CCHC fortifying their key services, expanding access, and making the necessary strategic investments to ensure the health system will continue to deliver world-class care to residents and visitors of the Cape.
Allen: Cape Cod Healthcare is not only the leading provider of medical care for Cape Cod residents and visitors, it’s also the region’s largest employer. How have you thought about and addressed the needs of both your patients and employees during the pandemic?
Mike: It’s been the most interesting time of my professional life. It’s also been very empowering and rewarding as a leader to know that at the end of the day, the entirety of our organization—from the Board down through rank-and-file employees—are all aligned in our mission. And the pandemic really clarified that mission: to protect our community, to treat them, to provide testing, to vaccinate, to be humbled to learn new policies and approaches to meet the needs of our people. The Cape has done so well with regards to COVID. However, most people don’t realize that, while early on we did not see the disease spread that many other regions across the Commonwealth did, that changed over the past 6 months. Our percentage of positivity has been far greater than any other community in the Commonwealth. So, the fact that despite that increase, we have kept our hospitalizations low and have achieved a vaccination rate of 91% among the eligible population – it’s been a real point of pride.
And naturally, protecting our community also means protecting our employees. We understood the importance of our work force. We are literally 8% of the Cape’s gross domestic product. So, we have to remain healthy not only to take care of our community, but also to support the region’s financial viability. For us, it’s been about meeting the needs of our community, while also seeing around the bend and planning appropriately.
Do you envision any permanent changes to how Cape Cod Healthcare delivers care as a result of COVID?
Yes, it has certainly caused changes. First, we learned a lot about the mitigation of disease. We understand the value of masking in a clinical environment and how critical it is to protecting ourselves and our patients. We learned new ways to mitigate spread, whether it be how we schedule testing and appointments or how we clean.
We also learned about the importance of being nimble and reimagining our approach to improve the patient experience. Our goal now is that patients never have to travel more than 15 minutes to receive primary care, 30 minutes to receive specialty care, and an hour to receive acute care. We’ve achieved this by creating more access points for our patients to receive care, which helps stop the high concentration of people in our ERs. When we started our urgent care vision 6 years ago, we saw 130,000 people in our ERs combined. This year, we will see 100,000 people in our ERs and 100,000 in our urgent care settings. And what’s so important about those urgent care settings is that patients are seeing the same Board-certified emergency room physicians and staff, but at a third of the cost. It’s a strategy we were focused on pre-COVID, and it has only strengthened during the pandemic. We’ve prioritized having multiple testing locations and delivering results rapidly.
Lastly, I believe COVID has really changed our ability to leverage technology effectively. Today, 30-35% of the care we provide is through telemedicine. And it’s not just primary care, but also behavioral health, dermatologic, neurologic, etc. This shift has been critical to creating greater access to care for our patients. They no longer have to disrupt their days by traveling to and from the hospital, and it’s especially important for immunocompromised individuals who can now receive care from the safety of their homes.
We are starting to come out of the pandemic – to an extent. What’s on the horizon? What opportunities and challenges do you see down the line?
I think a challenge will be staying disruptive in our space so we can continue to protect the health of our local community. We will need to find new ways to provide care. This is work we’re currently doing – whether it be through building a new cancer center, creating a new cardiology floor, expanding our ORs to bring new services into our hospitals, or developing a trauma program. We plan to continue investing in these key service lines to keep more people local. We’ve also built new ambulatory sites at the Wilkins Outpatient Medical Complex in Hyannis, the McGraw Medical Complex in Osterville, and the Stoneham Outpatient Center in Sandwich. We have created an Orleans Medical Building development plan. We want to keep care closer to people’s homes in the future.
We also need to create facilities that meet the needs of modern healthcare. I’m very proud that many years ago, we got ahead of the game and very deliberately got rid of all of our double occupancy rooms except for 10. Now, so many places are struggling with how to handle double occupancy rooms, how to build new and safer facilities, etc. That’s work we’ve already done. So, we’ll continue to find ways to create facilities that provide state of the art care.
In addition to fortifying our service lines and facilities, we’re finding ways to leverage technology, as I mentioned. During the pandemic, we transitioned to EPIC, an integrated, electronic medical record. With that transition, we were able to consolidate 29 disparate electronic medical records into one. I’m not sure that pursuing that transition during the pandemic was my smartest decision, but I’m glad we did it. As we learn to manage our population differently, keep them healthier than ever before, and communicate with them effectively through technological portals, EPIC will be key.
We saw during the pandemic that when local hospitals weren’t able to adequately care for their patients, they had to send them to Boston. That wasn’t the case for Cape Code Healthcare. Because of our community, our organization, and our philanthropic supporters, we can take care of critically ill patients on the Cape. We’re taking care of our population in a more effective and proficient manner than ever before. Now, looking forward, it will be a time to be innovative and disruptive – and that’s what we plan to do.
Can you speak to the importance of CCHC’s current campaign, and the phenomenal community support you’ve received?
We made it through COVID with nowhere near the government support that many other organizations received – which isn’t a complaint, but simply a fact. And that’s thanks to our philanthropic support. Because of our donors, we were able to survive the pandemic, deliver our services, fulfill our mission – and all while having an eye for the future.
Our philanthropic support allows us to be more progressive and invest in new strategies. That includes strengthening our urgent care program, investing in a nursing school to replenish a diminishing workforce, partnering with UMass medical schools to connect with future physicians that are the best and the brightest in the Commonwealth, broadening where people can receive care – the list goes on. Our philanthropic community sees our vision and understands that we can provide great care locally. They know that while there is world class care in Boston, there’s also exceptional care here on the Cape. Thanks to them, we haven’t had to slow down our plans; it’s their incredible support that allows us to secure a promising future.
One last question for you – what personal qualities have you drawn upon to lead your organization during the pandemic?
I really saw the pandemic as a once-in-a-lifetime opportunity to make a difference in so many people’s lives. Of course, there were some really dark days. But what motivated me was how fortunate I felt to work in a hospital – to walk the halls and be involved in every aspect of the organization. I feel lucky to be so close to the clinical environment. It’s still emotional for me – to think about what our teams faced. For months and now years, I’ve seen our frontline staff place the needs of the community above their own. And not just our front-line staff, but our entire institution. Everyone has been impacted by COVID so deeply, but none more so than the people who have saved countless lives every day for the past 21 months. That was motivation enough for me. Our organization needed me to make good decisions, to ensure we fulfilled our mission, to take care of our staff, and to make sure we came out of this on the other side. And I needed them, too.