Major changes are taking place in America’s health systems and we are starting to see the impact of some of these changes right here in Central Pennsylvania. Hospitals are no longer the desired “hub” for healthcare, rather free-standing emergency rooms, 24-hour emergency care centers and walk-in clinics are helping to keep people out of the hospital, while expediting their care.

Additionally, telemedicine is reshaping the need for brick and mortar facilities, placing a new emphasis on health systems acquiring “virtual” real estate. These emerging trends are intended to increase access to quality healthcare while allowing health systems to reduce overhead.

To help us answer some of the most important questions surrounding the changes taking place in Central PA’s health systems, we interviewed two guests who are highly knowledgeable on this very topic.

Christian Caicedo MD, MBA, CPE, FACHE is the System Senior Vice President and President of the Cumberland Division at UPMC Pinnacle. Paul Toburen, also with UPMC Pinnacle, is the Senior Vice President of Facilities and Support Services.

With a combined, vast experience in health systems operations, Dr. Caicedo and Mr. Toburen collaborate to lend their insights into how Central Pennsylvania’s health systems are rethinking the way they use commercial real estate.

Omni: Looking at how Central PA’s health systems currently function, what are some of the biggest challenges?

Christian/Paul: One of the most critical challenges we face in Central PA is access to care – not just any access, but the right kind of access. It’s a moving target we are trying to hit. Patients want access to fairly and competitively priced healthcare, in the right setting, with quality resources and skilled staff.

The challenge stems from the fact that we are all trying to live in two worlds: the fee for service world and the value based world. We can’t have it both ways and also provide access to quality healthcare to everyone in Central PA. There has to be a compromise somewhere.

Omni: As Central PA’s health systems see more and more value in serving the outpatient market, what strategies must be implemented to make this shift?

Christian/Paul: The key to shifting our focus to better serve the outpatient market is to make simple and immediate access to healthcare available to patients right where they are. Rather than asking patients to come to us in traditional office and hospital environments, we need to have access points in the work place, malls, retail spaces, home, etc. Health systems are now trying to acquire more virtual real estate than they are brick and mortar locations. This is evident by the more than 120 rural hospitals who have shut their doors since 2005!

Omni: With the use of telemedicine becoming more prevalent in our health systems, what are the pros and cons of diagnosing patients in their home?

Christian/Paul: The pros, as we touched upon above, will be the ease of access and convenience to the patient. It will allow physicians to see more patients in a day, reducing patient wait time and reducing patients exposure to germs and infections. Additionally, telemedicine is a great option for Medicaid recipients.

The cons, well that will evolve as the technology changes. Currently there are limitations as to the level of evaluation one can conduct via the virtual encounter. As technology evolves, (i.e. Haptic pressure feedback) we will have greater ability to perform better virtual exams and arrive at an accurate diagnosis through telemedicine.

Omni: Specifically, how will telemedicine impact brick and mortar healthcare facilities?

Christian/Paul: Simply put, the growing use of telemedicine will diminish the need for brick and mortar facilities and drive the demand for virtual real estate. If done thoughtfully and strategically, this should be a win for both patients and health systems. Speaking from the health systems standpoint, we can save a lot of overhead while providing patients with faster, more convenient care. Hospitals will stay play an important role in the overall health system, it’s just going to look a little different in the future.

Omni: What Central PA health systems do you feel are leading the way in rethinking how they use real estate?

Christian/Paul: We believe all Central PA health systems are rethinking the way we use real estate. The cost of construction continues to escalate. We are now looking at lease agreements versus building-to-own along with repurposing existing buildings to accommodate our current needs, but having flexibility for future needs as well. Speed to the market is critical in today’s healthcare industry, as we must accommodate the patients’ needs.

Given the transformation taking place in Central Pennsylvania’s health systems, and health systems worldwide, how do you feel about the changes taking place and where they will lead us in the future?

Join in the conversation by sharing your thoughts or questions!

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More about Christian Caicedo: Christian Caicedo MD, MBA, CPE, FACHE is the System Senior Vice President and President of the Cumberland Division, UPMC Pinnacle. He is the former Vice President of Operations and Medical Director for West Shore Hospital, and Interim Chief Medical Officer, Pinnacle Health System. He has served as Executive Director of Emergency Services and served as Clinical Director for Community Campus Emergency Department, Pinnacle Health System. Dr. Caicedo also served as medical director for Swatara Emergency Medical Services, and was a member of the Swatara EMS board of directors. Currently, he serves as Medical Director for Susquehanna EMS.

 More about Paul Toburen: Paul Toburen is currently serving as Senior Vice President for Facilities and Support Services for the UPMC Pinnacle Health System. Paul oversees fourteen departments with a primary focus on Construction Management and Real Estate. Paul has obtained his MBA and MS and is a member of the ACHE, ASHE, COAA, IFMA among other organizations.