Springfield Medical Systems manages under Covid-19 changes

By Shawn Cunningham
© 2020 Telegraph Publishing LLC

The ongoing response to the coronavirus pandemic has meant that health care systems have had to make changes to the way they work on a day-to-day basis while coping with shortages in gear and uncertain finances that can be difficult for rural providers and all the more so for Springfield Medical Care Systems which was preparing to exit bankruptcy this summer

Last week, Dr. Katrina Taylor told The Telegraph that the network of clinics that serve Chester, Londonderry, Ludlow, Rockingham, Springfield and several other towns in the region are trying to slow the spread of coronavirus by limiting the number of in-person visits they handle during the crisis.

“There are people who need to be seen in person,” said Taylor, “and we’re doing that using personal protective equipment.” And she said medical personnel are spending “a lot more time on the telephone” with patients, which limits “risk to patients and providers.” Those with respiratory issues are referred to a phone bank staffed by three to five registered nurses and doctors, physician assistants and nurse practitioners who do phone triage to determine where patients need to be referred.

Another way that health care providers – including the SMCS clinics – are reducing risk is by limiting the number of well visits and annual exams especially for those at the greatest risk of catching Covid-19.

“We know that people who are 60 and above with underlying conditions like cancer, heart disease, lung disease, liver disease can be devastated by Covid-19 so we are trying to keep them home and safe,” said acting CEO of Springfield Medical Care Systems Josh Dufresne. “Our clinicians reach out to these people by phone and had our staff schedule telemedicine visits, which, for the most part have gone pretty well.” He admits, however, that there have been “some growing pains,” while a number of patients and clinicians “embrace that service.”

By the same token, SMCS has opened a new clinic specifically to see people with respiratory issues. Housed in the Springfield Health Center at 100 River St.,  the walk-in respiratory clinic is open seven days with two providers and pediatric support. People with non-respiratory issues on the weekend – a laceration or a sprained ankle – can get care at the health centers in Ludlow or across the river in Charlestown, N.H.

Dentistry has been reduced by 95 percent due to the danger of transmission of the virus during procedures. And only serious dental problems such as abscesses are being treated. Consequently the Chester dental office has been closed temporarily and its staff has been moved to Ludlow. Dufresne noted they are trying to schedule waves of staff in a way that will protect them from infection and keep staff available.

The Lane Eye Clinic, which is also managed by SMCS, has also been shut and mental health visits have been cutback. All of this means that SMCS income is down, which, according to Dufresne, will have a “major effect” on the system’s projected exit from Chapter 11 bankrutpcy. That was expected to happen this summer but will be delayed,  although it’s difficult to say for how long, Dufresne said. The clinics had gone into the black in January and February, but with Covid-19 they have seen a 75 percent drop in income.  Dufresne noted however that state and federal aid should be in the works to keep things going.

What happens in a surge of cases?

Springfield Hospital is a Critical Access Hospital – a federal designation aimed at keeping emergency care available in rural areas. One restriction is that it can’t have more than 25 beds except during an during an emergency, when it is allowed more.

Dufresne said that a lot of work has been done to remove the restrictions and Taylor noted that the hospital’s capacity – including surgical recovery areas, pre-anesthesia care unit and other areas – could go as high as 34 beds. As state officials plan for a surge of new Covid-19 cases in Northern Vermont with three new centers in Burlington, St. Albans and Barre, they have told The Telegraph that they believe there may not be a surge in this are that would go beyond Springfield’s capacity.

State officials had said that many of the decisions on siting of surge centers would be driven at a local level by the doctors on the ground. Asked if they had been contacted by anyone about this both Dufresne and Taylor said they had not.

Taylor did praise the flexibility of the staff at the hospital and clinics in a situation where events are constantly changing and people are being asked to adopt new procedures.

Community shows support for medical staff

The hospital and clinics have had great support from the community according to Dufresne who noted that driving up the hill to work and seeing the encouraging signs that people have put the “really puts a spring in your step.”

“I’d like to say that the most important way the community can support us is by staying home, practicing excellent hand hygiene and practicing physical distancing,” said Taylor noting that she doesn’t like the term social distancing. “That’s what we need the most because that’s going to have the most likelihood of preventing the system from overloading.”