By Cindy Krischer Goodman | cgoodman@sunsentinel.com | South Florida Sun Sentinel
Broward County hospitals had more than 1 million emergency room visits last year, a number expected to rise with the county's aging population.
Providing medical care to those emergency room visitors and the more than 232,000 people admitted annually will become more challenging for Broward County hospitals -- primarily because of a significant rise in shortages projected in the health-care workforce.
On Wednesday, health leaders in the county highlighted how Broward hospitals have invested in electronic medical record systems, launched medical training programs and stepped up collaboration among themselves. The leaders also revealed significant challenges ahead in delivering medical care as doctors and nurses in the state retire, new artificial intelligence plays a role in medicine, and financial pressures mount.
"Our healthcare institutions have risen to meet the needs of our evolving population," moderator Ray Berry told business executives with the Broward Workshop who gathered to learn more about opportunities and challenges facing the county's healthcare system.
Yet Berry, a healthcare executive and Broward Health commissioner, also highlighted the workforce predicament: Florida will be short 31,000 nurses and 86,000 physicians by 2035, when about 20% of the existing workforce retires. This will happen while Florida's growing senior population needs more medical care.
"When it comes to hiring, we are doing much better today than we did about a year and a half ago," said Aurelio Fernandez, interim CEO of Memorial Regional Hospital. "Although we still have a long way to go."
The staffing shortages will likely push wages higher across the industry, adding financial pressure on hospitals. Berry pointed out that hospitals already operate on "razor-thin margins."
Shane Strum, CEO of Broward Health and interim CEO of Memorial Healthcare System, said the cost of care in the U.S. is high compared to other countries for various reasons. "It's expensive to train physicians of tomorrow. Clinical trials are more expensive than ever before. Pharmaceuticals are expensive. The length of stay that patients are staying in the hospital is more, hence the increase."
A 2024 report by consulting firm Kaufman Hall found that an alarming 40% of U.S. hospitals are losing money.
"That's a bigger problem than people realize because if a hospital closes, the community loses care," Strum said. "Everything that we do makes a huge difference here."
Broward County has 23 hospitals and 7,100 licensed beds to serve about 2 million people with any medical need.
Technology, particularly artificial intelligence, is expected to advance significantly in the next decade, forcing health systems to embrace it. That involves a financial investment.
Four of Broward's health systems -- Holy Cross Health, Broward Health, Memorial Healthcare System and Cleveland Clinic -- now share electronic health records through a program called Epic. Broward Health, the latest system to adopt Epic, will spend $500 million on the technology. Doctors can see a patient's records from any other health system that uses Epic. The software also is programmed to send out alerts.
"Last year nationally, there were 173 million potential adverse drug events interactions that were avoided by Epic warning the doctor that they could not give one drug or another," Berry said. "There were 135,000 surgical errors prevented with time-outs before operations that Epic warned these folks about. This is the product that we've all invested in to bring to Broward County."
Dr. Conor Delaney, CEO of Cleveland Clinic Florida, said his health system is training EPIC to pick up alerts when patients are sick, even before a doctor would notice. "It could allow us to give antibiotics earlier and improve patient outcomes," he said.
Cleveland Clinic also is looking into using AI scribes to take medical notes. "Some doctors might be seeing 20 to 40 patients a day ... and yet they have to spend hours on documentation. This kind of technology will help make them more efficient."
In the future, Broward health-care systems will need innovation to care for the aging population and the underserved. Both groups have the potential to strain emergency services.
Broward Health and Memorial Healthcare now have mobile units that go into underserved areas and offer health and wellness screenings. Cleveland Clinic has launched a hospital-at-home program to provide patients, particularly seniors, care in their homes rather than be admitted.
Dr. Chad Perlyn, chief medical officer with Nova Southeastern University in Davie, said his university works to graduate medical professionals who will participate in innovation. "We are attracting unbelievable talent to South Florida in our physicians and researchers," he said.
A challenge and opportunity going forward, he said, is to get the various professionals who treat a hospitalized patient to communicate. "As we have to think about the future, we have to think about how we integrate better."