NEJM Catalyst Publishes Case Study Detailing Success of Arizona Surge Line, Driven by Central Logic’s Technology Platform
Public-private collaboration has ensured COVID-19 patients and healthcare resources are balanced across the state even during times when Arizona was No. 1 hotspot in the world
“Collaboration on the Arizona Surge Line: How Covid-19 Became the Impetus for Public, Private, and Federal Hospitals to Function as One System” was authored by physician leaders from AZDHS as well as Arizona hospital and health system leaders from across the state and Central Logic clinicians assigned to the Surge Line. Authors tell the story of how the Surge Line, which features a 24/7 referral line, has facilitated the rapid placement and equal distribution of thousands of patients with COVID-19 across the state since April 2020.
“It is an honor to have played an active role in a project that has helped so many people in the state of Arizona get the care they need by working with public health leaders to orchestrate the transfer of more than 6,000 patients with COVID-19,” said Darin Vercillo, MD, chief medical officer and co-founder of Central Logic. “This kind of collaboration was our vision when we founded Central Logic over a decade ago, and it is tremendously humbling and gratifying to see it come to fruition during the pandemic we have been experiencing since early last year.”
Preparation and Rapid Action
The origins of the Surge Line date back to March 2020 as state officials were observing the surge of patients with COVID-19 in New York City and how hospitals were struggling with overcrowded facilities and finding appropriate care for critically ill patients. AZDHS met with the major health systems in the state to discuss a unified, statewide transfer service for patients with COVID-19 to expedite placements and admissions while load-balancing patients and healthcare resources such as medical/surgical beds, intensive care unit (ICU) beds, ventilators and specialist care.
The health systems met and agreed to proceed with the public-private collaboration, marking an understanding that previous competitors would now be acting as collaborators in order to put patients first. With implementation support and technology solutions from Central Logic, the Surge Line was up and running in less than two weeks. It was not until months later in late June and early July when the state experienced its first major surge of patients with COVID-19, which required the Surge Line to transfer nearly 70 patients per day at its peak.
“The Arizona Department of Health Services and hospitals in Arizona worked together to create this integrated, efficient statewide system to protect patients and hospitals against unbalanced hospital surges,” said Lisa Villarroel, MD, MPH, Medical Director of Public Health Preparedness at AZDHS and the Surge Line.
Delivering Statewide Visibility
Efficiently orchestrating care across the state required a new structural capability for many hospitals and health systems: real-time bed visibility. Historically, referring physicians would need to call other hospitals to determine the availability of beds, specialty physicians and equipment, such as extracorporeal membrane oxygenation (ECMO) machines. The Surge Line agents who coordinated the care had visibility over all those crucial elements through the Central Logic platform powering the system.
“Real-time bed visibility was a new feature that Central Logic was preparing to launch for our clients when the Surge Line began, which meant we had an opportunity to test the capability on its largest scale yet,” said one of the article’s authors, Luke Smith, DNP, RN, NE-BC, CCM, director of the Arizona Surge Line and client operations analyst at Central Logic. “Bed Visibility proved to be well up to the task by delivering a clear and reliable overview of capacity for the more than 130 hospitals across the state that are part of the Surge Line. We have since launched Bed Visibility for use by health systems and hospitals everywhere.”
After four months in operation, Surge Line participants were surveyed and asked to rate the system on a 10-point scale. Hospital staff who responded to the survey awarded the Surge Line nearly the highest ratings (between 8.2 and 9.0) on each question, with the highest rating (9.0) for its ability to transfer patients with COVID-19 to higher levels of care.
Continuous Improvement
The Surge Line is maintaining those high levels of satisfaction by continuously improving the service to referring hospitals, including improvements in protocols and data collection and development of analytics to examine out-of-region transfer trends and to refine calculations of time to bed placement.
Eventually, a time will come when the Surge Line will not be necessary to orchestrate the care for patients with COVID-19. The statewide system, however, has numerous applications beyond the pandemic, such as any future hospital surges due to wildfires, terrorism or other public health threats, and is piloting its use for transferring patients with influenza.
“It is our intention to maintain the Surge Line as a public health tool,” Dr. Villarroel said. “The Arizona Surge Line has been a highly successful initiative within the state, delivering a valuable public health resource to reduce avoidable care delays, prevent hospital overcrowding and contribute to improved patient outcomes.”
About Central Logic
For health systems and hospitals, healthcare access and orchestration are life-saving endeavors. Central Logic is a pioneer in the space and was founded solely to support this mission. Our flexible, purpose-built access and orchestration solutions ensure efficient patient navigation across health systems and through the continuum of care, and deliver the necessary controls to elevate revenue capture, clinician effectiveness, and patient outcomes. Clients count on Central Logic to deliver superior real-time visibility across their networks while offering operational, clinical and technical best practices to drive strong growth, reduce length of stay and minimize avoidable delays, today and into the future. Based in St. Paul, Minn., Central Logic has a 93% customer retention rate and has been named a “fastest growing private company” by both Inc. 500 and Utah Business Magazine. For more information, visit www.centrallogic.com.