When talking about one of the primary objectives of the Goshen Health system, President and CEO Randy Christophel does not sound like your typical leader of a health network.
“We have this weird goal where the hospital should be empty,” Christophel says. “That's a very different philosophy than most health systems who see it as a success if the place is full.
“That's not the goal here.”
Christophel leads the charge with what he calls a “proactive philosophy” in which Goshen Health focuses as much on preventing illness and diagnosing major issues early as it does treatment.
As options regarding health care have expanded, so has Goshen Health, but in a way that ensures the small-town, caring feel of a community health network. The Goshen Health network now spreads across four counties and over 30 locations, with Goshen Hospital in Elkhart County the primary base of operations.
Also included in the network is the Goshen Health & Vascular Center, the Goshen Center for Cancer Care and the Goshen Surgery Center.
Expansion continues, with the groundbreaking of a new NeuroCare Center in Goshen in April.
Across all of its platforms, Goshen Health's goal remains consistent — prevent big health issues as much as possible, which then controls costs.
“We have been in business for 104 years, and for 90 of those years it was, 'Hey, if you get sick or get hurt, come see us and we will do a great job taking care of you,'” Christophel said. “Now, it is much more proactive. How do we keep you out of here? How do we help you manage your health status so that you don't go south and get admitted here?
“It's much more of a reaching out ... philosophy.”
One of the more innovative ways in which Goshen Health tries to keep people out of its facilities is telehealth units. Distributed to patients with multiple, chronic conditions that need constant oversight, the take-home system anchored on an iPad helps measure blood pressure, weight, sugar levels and other important body vital signs.
Physicians are able to monitor changes and adjust prescriptions based on the telehealth feedback as well as reach out via a video feed to check in with the patients on an even more personal level.
“Our mission is to improve the health of our communities,” Christophel said. “When you take that seriously, you've got to bring services to where people live in their homes and for those folks who struggle to manage their chronic conditions. It's important you bring things to them.”
In the continuing effort to control costs and keep people out of long-term admittance to the hospital, Goshen Health also offers a significant amount of health screenings either free or at minimal cost. Included in the extensive offerings is a free lung screening which involves a low-dose CT scan to help identify lung cancer at an early stage, opening up a wider variety of treatments as opposed to an advanced case.
“You can't improve total cost of care unless you are keeping people healthier,” Christophel said. “You've got to keep driving up your breadth and depth of services.”
Goshen Health also has devoted extensive resources to end-of-life discussion and decisions. According to a 2012 article in Money magazine, one out of every four Medicare dollars, more than $125 billion, is spent on services for the 5 percent of beneficiaries in their final year of life.
A study by the Mount Sinai School of Medicine found that the average out-of-pocket expenses in the final five years of life averages around $39,000, not including people diagnosed with long-term illnesses such as Alzheimer's.
“There's always one more thing we can do for you, but that doesn't exactly mean it improves your quality of life,” Christophel said. “We are investing a lot in that end-of-life discussion. If we do a bunch of treatments and your last six to nine months are poor quality, we aren't helping you.
“We want to provide the choices available and help people make good decisions and be able to meet their personal goals.”
Goshen Health's vision statement has it focusing on an integrated health care system across all of its locations, offering services in a wide variety of medical fields. To Christophel, it is important that the network does without sacrificing its identity.
“I hear stories all the time where people who visit us say, 'It didn't feel like I went to a huge institution where they didn't care about us and we were a distraction to their daily duties,'” Christophel said. “That's part of the beauty of being an organization that has been very community-oriented and has expanded dramatically into serving a lot of communities in a broad geography.”