Taking Health Delivery to New Heights

Darmita G. Wilson, Vice President of Northern Light Health has 35 years of experience in the healthcare industry, holding various operational and executive positions. She has her expertise in medical logistics was instrumental in addressing operational challenges.​ 

Please share an overview of your leadership journey and experiences in the healthcare industry and explain how your industry experience and business strategy is helping you in your current role?

I have accumulated 35 years of experience in the healthcare industry, holding various operational and executive positions. In the past decade, I have primarily focused on executive roles. Before joining Northern Light Health, I worked as a national healthcare consultant for BE Smith. Initially, I came to Northern Light on a six-month assignment, which got extended to two years due to the unexpected onset of the pandemic. During this time, my expertise in medical logistics was instrumental in addressing operational challenges.

Initially, I was engaged in operational tasks at one of the local hospitals within the Northern Light system. Subsequently, I was invited to apply for a systems position, leading to my relocation to Maine. I have been in this role for approximately 16 months. As a system leader at Northern Light Health, my responsibilities encompass the overall operational management of the medical groups comprising 10 hospitals and numerous other facilities. My focus lies in overseeing post-pandemic recovery, addressing staff shortages, implementing strategies for staff retention and recruitment, streamlining credentialing and verification processes, and simplifying workflows.

My expertise primarily lies in ambulatory services and operations, which has been my specialty as a COO of a medical group.

Could you please elaborate on how you have utilized your experience and skills to navigate healthcare organizations during periods of accelerated growth, rapid change, and the challenges presented by labor shortages?

When it comes to managing the shift in healthcare delivery post-pandemic, it is crucial to recognize that the healthcare landscape will never be the same. The pandemic has brought to light certain aspects that we were previously unaware of or reluctant to change due to the absence of a pressing need. In light of this, it is important to reevaluate the necessity of traditional brick-and-mortar healthcare facilities, considering the advancements in telehealth and technology that can effectively meet the needs of our patients.

One significant issue to address is patient access, particularly in rural areas where establishing or sustaining brick-and-mortar facilities can be challenging. The shortage of staff to adequately support these facilities further compounds the problem. To overcome these barriers, leveraging telehealth and telework offers opportunities to extend the workforce beyond geographical boundaries.

Could you share a recent project initiative where you successfully implemented technological trends to achieve success?

Currently, I am working on developing a progressive career model to address the existing provider shortage and the significant number of healthcare providers nearing retirement age, which accounts for approximately 43 percent of the national healthcare workforce. The primary goal of this model is to strategically plan for retirement or reduced work schedules for experienced doctors, ensuring a sustainable transition. By implementing the progressive career model, we aim to allow ample time for recruitment and avoid disruptions in patient care. For instance, recruiting a cardiologist typically takes around two and a half years. If a cardiologist decides to retire and provides only a 90-day notice, it becomes challenging to find a suitable replacement within that short timeframe. Such transitions adversely impact patient satisfaction and continuity of care. To address this, the progressive career model proposes pathways for doctors to gradually reduce their clinical schedules while contributing to other care gap measures, even after retirement.

This progressive career model emphasizes flexibility in how they approach retirement as it is important to recognize that physicians dedicate a significant portion of their lives to their medical careers, investing 26 years in education and typically working for 30 years or more. While retirement may initially seem appealing, many physicians find it difficult to adjust to a life without the demanding schedule they have grown accustomed to. For instance, they may choose to work as part of a pool staff, providing coverage for vacationing or absent physicians and can engage in telemedicine or e-consults, offering advice to primary care providers regarding basic care protocols before a specialist referral is necessary. Preceptorship programs can also be established to educate and train new providers, such as physician assistants and additional nurse practitioners, ultimately improving the overall physician model and enhancing patient care.

During the transition to retirement, the progressive career model suggests gradually reducing the full-time equivalent (FTE) workload. This may involve transitioning to a 0.75 FTE or even a half-time schedule. Within this reduced workload, physicians can focus on addressing care gaps, conducting patient follow-ups, and improving key performance indicators related to patient satisfaction and outcomes.

How do you envision the future of healthcare, considering the potential transformations in the healthcare industry?

I anticipate a decrease in the number of acute care hospitals, with a greater emphasis on the involvement of Ambulatory Surgery Centers. This expectation is supported by recent articles highlighting the potential shift of certain services away from traditional hospital settings. The reduction in workforce resulting from the pandemic, combined with advancements in medical technology, has played a significant role in this trend.

“It is crucial to foster an innovative mindset to understand the operational intricacies and nuances of the latest technology in healthcare"

For instance, consider the evolution of gallbladder procedures. In the past, such surgeries required a hospital stay of approximately five days, whereas now they are performed on an outpatient basis. Similarly, hip replacements and knee replacements are increasingly conducted with shorter hospital stays, typically 24 hours instead of one to two weeks. Around 30 sub-service lines encompass these areas, accounting for approximately one-third of hospital outpatient revenue and 18 percent of the regular volume of hospital outpatient departments. Notably, certain procedures, such as coronary interventions, total hip arthroplasty, total knee replacements, spinal fusion, spinal decompression, and laparoscopic cholecystectomy, have already experienced a shift toward ambulatory service centers, which are poised to gain market share for essential hospital procedures.

Additionally, in my opinion advanced-stage procedures at risk of future shifts predominantly include those in neurology, pain management, ophthalmology, general surgery, and orthopedics. Intermediate stage shifts may be concentrated in ENT, radiology, and gastroenterology service lines. It is widely acknowledged that patients tend to recover better in a home environment, which reduces the risk of infection associated with hospital stays and exposes them to fewer disease entities. All of these are indicators in terms of shifting from hospital settings that I predict will be happening in the future.

What will your word of advice be for fellow peers in the industry?

For fellow peers in the industry my advice would be to embrace a curious and receptive mindset like a sponge. It is crucial to foster an innovative mindset to understand the operational intricacies and nuances of the latest technology in healthcare.  This involves exploring avenues for streamlining operations and harnessing the potential of technology and AI.

Our primary focus in healthcare delivery should be on prioritizing the patient-centric approach while promoting equitable access, ethical practices, and responsiveness to patient needs rather than generating a business model to maximize revenue.