Ballad Health's expanded command center leverages tech in medicine

JOHNSON CITY — Under dim lights and flickering monitors, more than a dozen people work diligently at their computers. With headsets on, they tap through numbers, patient details and video feeds, talking to each other in low voices. The scene looks like something out of an air traffic control tower — and it's what Ballad Health executives are aiming for. "This is like air traffic controlling, except for controlling patients instead of planes," said Penni Kyte, Ballad's senior vice president of technology-enabled care.The room, named "Mission Control," is the newly renovated brain of Ballad Health's Clinical Command Center. Its goal is to efficiently place patients at facilities that match their needed level of care, cutting down on cost and time for providers and patients. The center also serves as a hub for other healthcare services across the region, including emergency medical services and management agencies, 911 centers and air medical providers. "How do we identify patients that are critically ill to get them to the appropriate level of care?" said Dr. Clay Runnels, Ballad chief executive physician. "How do we bring resources to those that don't need to be transferred so that they can get access to those specialties where they are and maybe stay closer to home, closer to family?" The facility was an $8 million investment funded mostly through grants. Kyte said $4.8 million from the Healthcare Resiliency in Tennessee program created the command center. Grants from the state and U.S. Department of Agriculture have also funded the center's telemedicine initiatives.Staff and executives at the center initiate transfers between facilities, walk physicians through complex procedures with telehealth options and activate healthcare teams so they're ready and waiting when a patient in crisis arrives. Ballad reports that its transfer network has reduced bed assignment time by two-thirds, saved $4 million in patient transports and avoided more than 6,000 unnecessary patient transfers. "This vision really came out of COVID when we saw the bottlenecks [in care]," Kyte said. "We're continuing to grow. This is just the beginning of what we're going to end up being." The command center is also leveraging telemedicine, including multiple pilot programs. Through its school-based telemedicine program, for example, the network coordinates virtual visits for 132 schools across Virginia and Tennessee. Trained staff, or "virtual sitters," also monitor patients with cardiac issues or at high-risk for falls. Through cameras and artificial intelligence technology that indicates when a patient moves, staff watch 70 fall risk patients a day. Since the start of its fiscal year in July, the center has counted more than 23,000 saves that prevented patients from falling."We can alarm and get people in there," Kyte said. "[They're] constantly talking to the facility and the frontline nurse." Ballad executives said they're pursuing more grants through the rural health transformation program, a five-year federal fund created to invest in rural health in the wake of upcoming Medicaid cuts. The fund has allocated $206.9 million to Tennessee. The federal initiative pushes states toward technology innovation. Ballad is pursuing grants in both Tennessee and Virginia to build clinics that can house telemedicine and in-person care, expand telehealth options to clinics outside of Ballad, implement AI solutions and broaden the radio system in Southwest Virginia. Ballad Chief Executive Officer and Chairman Alan Levine said the command center infrastructure gives the healthcare system flexibility across its 29-county footprint, allowing it to backfill services. "[Medicaid cuts are] a material and catastrophic cut for us," he said. "What we're doing here actually will help be a buffer for our hospitals against that, because even if you have to cut services in some of the hospitals just to deal with the financial cuts that we're going to get, that doesn't necessarily mean the community will lose the service."