COVID Chronicle June 2021

COV ID- 19 CHRONI CLE

MAINE MADE US DETERMINED

Northern Light Health’s response to a global pandemic

UPDATE JUNE 2021

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INTRODUCT ION

Northern Light Pediatrician Maria Rutmann, MD receives the COVID-19 vaccine at Northern Light AR Gould Hospital in Presque Isle.

THE QUALITY OF STRENGTH LINED WITH TENDERNESS IS AN UNBEATABLE COMBINATION. - DR. MAYA ANGELOU

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Despite the challenges of the last year, we are resilient, stronger, and prepared for the future ahead. There is no doubt about it, the last year and a half has come with challenges that we had never seen the likes of before. Navigating the ever-changing environment, bracing for the anticipation of new surges, and continuously adjusting our course to best serve Maine people has been strenuous to say the least. But, it hasn’t been without its golden moments as well. I have witnessed the continued perseverance of an exceptionally skilled statewide team—a team that won’t quit until we do everything we can to safeguard all the communities we serve. Whether its hosting vaccine clinics for a remote island community, partnering with community organizations to reach out to our underserved and immigrant populations, or ensuring our most vulnerable, homebound individuals have access to the vaccine and necessary care, we have been proud to be there and will continue to be no matter what the next chapter brings. We have brought you two COVID-19 Chronicles, the first one was a year ago and the second in December, 2020. These reports have provided a snapshot and high-level overview of our strategic and rapid response to the pandemic. While it’s difficult to squeeze six months of ongoing, fast-paced activity into one report, we hope you have found them to be informative. This third report is a continuation of our story, focused on our vaccination efforts and ways we have adapted services to ensure all can safely access the services they need. Now, as we start to turn a corner, we are excited to share with you how we are setting the stage for an even better, highly integrated, and thriving Northern Light Health. While we haven’t yet been able to fully close the book on COVID-19, there is light up ahead. And, we promise to always be here for you—a community treasure that will work tirelessly to make you proud. I am filled with gratitude for your endless support and trust in our team throughout Maine. If there is one thing that can be said with absolute certainty, it is that the last year has made us resilient, stronger, and well prepared for the future ahead. Thank you for the honor of serving you.

Timothy J. Dentry, MBA President & CEO

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A WORLD WI TH COV ID- 19

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It will be a long time before we have a world without COVID-19, if that’s even possible. However, we are well on our way to a world where it is a preventable and manageable disease.

COVID-19 and Beyond… Just over a year ago, COVID-19 was a newly discovered virus. Over the past 17 months, scientific and healthcare leaders have discovered how to prevent transmission and developed not just one but several effective vaccines. Using these tools and knowledge, Northern Light Health and our communities have started slowly, steadily returning to the next normal.

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A WORLD WI TH COV ID- 19

Northern Light Home Care & Hospice Quality Director Erica Brochu (left), with Cathy Bean, RN, Manager of Clinical and Community Health Services, donned protective gear to screen and test Portland, Maine’s homeless residents for COVID-19.

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Coming Through The physical challenges of the past year have been well chronicled, the collective emotional trauma is something that will need to be addressed. In our last issues of the COVID Chronicle, we talked about the continued work of Northern Light Acadia Hospital to serve our patients, communities, and our staff. Healthy Life Resources, powered by Northern Light Acadia Hospital, was launched to complement services offered by the Employee Assistance Program (EAP). With expertise in helping people exposed to prolonged stress, anxiety, and trauma, the program offers a comprehensive, coordinated, and actionable set of supports for all employees to promote their overall well-being, and support a strong and functional workforce throughout and following this outbreak. The resource coordinates services locally at each Northern Light Health member to respect the needs and culture of each organization.

Support. Resiliency. Connection.

The Healthy Life Resources program has been so successful that it is now being offered to local businesses, schools, and other organizations as a service line. Program offerings include: • myStrength: self-guided support: a secure tool that connects employees with hundreds of self-care resources, including mental wellness coaching. • Training from mental health experts: web- based training for leaders and staff, focused on mental health. • Group support: virtual employee wellness offerings in a group setting including yoga, group exercise, support groups provided by EAP, and more. • Crisis management briefings: 15-minute meetings at the beginning and end of shifts, focused on maintaining employee wellness, minimizing anxiety, and retaining productivity. • Critical incident and stress management: on-demand debriefing, provided by Northern Light Acadia Hospital clinical experts, when a department or organization experiences a localized, acutely stressful event.

“Healthy Life Resources has provided tremendous support over the past 14+ months. A highly competent team of professionals led by Angela Fileccia has engaged both staff and leaders in conversations covering a range of topics. We have provided several opportunities for leaders and staff to learn strategies to increase resiliency, techniques to combat burnout, and mechanisms for coping with work and family stress. In addition, the MyStrength app has been welcomed support for Home Care & Hospice’s workforce, 90% of which are remote workers.”

Jane McGillicuddy RN, SHRM-SCP Director Human Resources, Northern Light Home Care & Hospice

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A WORLD WI TH COV ID- 19

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Taking Care of the People Who Take Care of Maine Throughout COVID-19, Northern Light Health has provided safe, high-quality care. While the pandemic may have held the world’s attention, patients have still required emergent care and care for chronic conditions. Telehealth services that ramped up during the peak of COVID-19 continue to be a popular alternative, but more and more, patients are returning to in-person visits and are catching up on screenings. For those patients who may not realize how safe it is to come in for care, or just how behind they are, many practices have reached out to check in, see how they are doing, and get those appointments scheduled.

“I underwent full knee replacement surgery at Northern Light Mercy

Hospital in April. I felt well cared for with full regard for my safety and wellbeing. Following the procedure, the in-home physical therapy with Northern Light Home Care & Hospice could not have been better. I would absolutely recommend both Northern Light Mercy Hospital and Northern Light Home Care to anyone in need of their services.”

John Shaw Springvale, Maine

A patient visits with Hannah Campbell, PA-C Northern Light Primary Care, Waterville.

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BU I LDING ACCESS

Scheduling Site Goals: • Make access to vaccines easy for all who were eligible to be vaccinated. • No dose left behind – ensure efficient use of vaccine, getting doses and appointments to areas of highest demand. • Build on existing workflows and systems, to make the process easier for staff and to ensure that vaccination information made it to the electronic health record. • Build a system flexible enough that it could change and adapt as access to vaccines changed.

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Building Access: An Online Solution to Speed Up Vaccinations When vaccination planning kicked off in the summer of 2020, we knew that community members would need to be scheduled for their vaccines. At that time, it seemed like the solution would come from the state or federal government. As vaccine development progressed, it quickly became apparent that an approved and authorized vaccine might outpace the development of a vaccination scheduling system. Northern Light Health’s incident command teams knew that without a scheduling solution, vaccinating hundreds of thousands of people would be next to impossible. So, the vaccination planning team, Information Systems, and Marketing and Communications web development team got to work.

“Our digital services team at Northern Light Health have been instrumental in providing the technical capabilities necessary to accomplish the type of coordinated vaccination effort we have launched across our health system. Digital Services developed an entirely new platform in two weeks and has been nimble in implementing enhancements throughout this process. Without their assistance, we would surely not have been able to implement this effort as effectively. These tools will also be critical to our efforts in moving to community vaccination as well, given advanced scheduling capabilities will be a necessity with these vaccines.”

Matt Marston, PharmD VP, Northern Light Pharmacy

Bumps Along the Way The initial demand for COVID-19 vaccinations was higher than anticipated, hindering our website’s functionality during the early days of appointment releases. This created the need to scale up accessibility on the website quickly and repeatedly. Ultimately, we installed a virtual waiting room to ensure that community members would not lose their place in line. While challenges were briefly frustrating, they were resolved quickly resulting in a scheduling experience that works so well that it remains in use, even with a state solution online.

First Doses / Second Doses DAILY DOSES ADMINISTERED COVID Vaccine

(135) | (44.3%) 1st doses vs. prior wk (656) | (31.3%) total doses 205.4 avg daily doses last 7 days  

Jan

Feb

Mar

Apr

May

Jun

Source: Cerner | Data as of 6/17/21 Note: Cerner data does not include Northern Light Medical Transport and Home Care & Hospice.

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BU I LDING ACCESS

Deb Sanford, VP of Nursing at Northern Light Eastern Maine Medical Center answers a call to the Northern Light Health Call Center. Most call center staff were able to work from remote locations, which supported efficiencies and recruitment efforts.

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A Solution for Everyone

While the lion’s share of appointments were being made online, we knew that many of our patients and communities were without access to online resources. The COVID-19 Vaccination Hotline changed from an information hotline, to one of the most dialed numbers in the state. Staff from patient access and revenue cycle as well as volunteers who stepped up from other areas, began answering phones to schedule patients who couldn’t use the online system.

HIM Associate Diane Smith takes a call to the Northern Light Health COVID-19 Vaccination Hotline.

“When asked to help run the COVID-19 call center, I was nervous but excited. I had never been involved with a call center before, but wanted to be a part of the amazing work Northern Light Health was doing to take care of our patients. There were many challenges thrown our way, but the amazing volunteers that gave their time met each one with a smile on their face. I think we all learned a great deal and had some wonderful conversations with our patients. Being able to help them made any challenge worthwhile. The volunteers were all amazing and I want to thank each and every one! Without them we would not have been successful.”

Missy Hafford, CRCP-I Manager Operational Support & Process Improvement Enterprise Revenue

Cycle - Business Support Services

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VACC INAT IONS

Dr. Scott Wiseley, PharmD, Clinical Pharmacist, Northern Light Eastern Maine Medical Center Inpatient Pharmacy measures doses of Pfizer vaccine at the Cross Insurance Center mass vaccination site in Bangor.

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Mass Vaccination: The Fast Track to Herd Immunity While we’re not there yet, the state of Maine’s mass vaccination efforts, launched in early January, have our state well on the way. As of June 17, 2021, more than 62% of eligible Mainers had received at least their first vaccine . After months of preparation, Northern Light Health was ready to step up and lead the opening of nine large scale vaccination sites around the state, designed to get community members in, informed, vaccinated, and on their way in 30 minutes or less. As this report was being finalized Northern Light Health launched a plan to scale back and ultimately close the large-scale vaccination sites, such as the one at Cross Insurance Center in Bangor. It was time to meet people where they are or otherwise make it easy for them to get vaccinated. Community and school pop-up clinics were launched to meet this need.

Total Doses 1-24 25-99

100-999 1,000-9,999 10,000+

Northern Light Health staff organize supplies while setting up a mass vaccination site at the Cross Insurance Center in Bangor.

© Mapbox © OSM

A student from the University of Southern Maine School of Nursing vaccinates a community member at the large scale vaccination site in South Portland managed by Northern Light Home Care & Hospice.

Source: Cerner | Data as of: 6/17/21 Note: Cerner data does not include Northern Light Medical Transport and Northern Light Home Care & Hospice

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VACC INAT IONS

Vaccine pop-up clinic in Palmyra, Maine

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Meeting People Where They Are Maine’s beautiful and diverse topography is one of the reasons people choose to live here. Unfortunately, the old adage of “you can’t get there from here” applies to mass vaccination sites, too. Northern Light Home Care & Hospice, an integral player in testing outreach for isolated groups and communities, stepped up immediately to ensure that our more rural communities and homebound patients had access to COVID-19 vaccines. Between January - May, this team held 112 pop-up clinics in 31 communities, and visited 335 homebound patients, along-side running a large-scale vaccination site at the Maine Mall in South Portland. Healthcare for All A major focus during COVID-19 has been reaching out to communities that might miss out on care, testing, and vaccination. It helped that Northern Light Health already had robust translation services and outreach in place, but we knew that outreach to our immigrant and underserved communities would be important, and we would rely on leaders of those communities leading the way. Northern Light Mercy Hospital, located in Portland, took steps before their vaccination site opened at the Portland Expo to build those bridges. “All along, we’ve been working directly with multiple partner organizations to facilitate both registration and vaccination of large groups of new Mainers. While all sites have access to Northern Light Health’s Stratus translation solutions, at the Expo, we also have face to face interpreters and cultural brokers on site for every appointment,” shared Melissa Skahan, vice president of Mission Integration at Northern Light Mercy Hospital. Outside of Portland, Northern Light Home Care & Hospice deployed Health Equity pop-up clinics to underserved areas.

To communicate clearly and meet patient needs, vaccine information is made available in several languages.

“All along, we’ve been working directly with multiple partner organizations to facilitate both registration and vaccination of groups large and small of new Mainers. At the [Portland] Expo, we also have face to face interpreters and cultural brokers on site for every appointment.”

Melissa Skahan VP Mission Integration

Northern Light Mercy Hospital

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VACC INAT IONS

Brittany Willey and Daughter Alivia wait the mandatory 15 minutes after Britanny’s vaccination at the Northern Light Health mass vaccination site in Ellsworth.

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Beyond Mass Vaccinations Not only did vaccines arrive faster than we anticipated, the positive response from our communities has been overwhelming, leading to the wind down of large-scale vaccination sites across the state through the month of May. While thousands of people may not be seeking vaccine every day, there are still pockets of underserved populations and people who haven’t been able to get the vaccine for one reason or another. Large scale vaccination sites may have been the starter’s pistol for herd immunity, but it’s long term vaccination planning at walk in care centers, for inpatients in hospitals, and at primary and specialty care practices that will get us over the finish line.

“For many people, waiting until they could get vaccinated at their primary care provider was the only solution they ever considered. They know their provider and their care team and know that we take good care of them. Every provider I know is looking forward to meeting with patients and answering their questions. Just because someone hasn’t sought vaccination at a large-scale clinic doesn’t mean that they won’t get vaccinated, it may just mean it wasn’t the right setting for them and we’re here to help.”

Gavin Ducker, MD SVP and Co-President

Vaccinations aren’t the only COVID-19 specific service that will need a shifting long-term plan. As more people are vaccinated, and fewer people contract COVID-19, offsite testing will also be changing. The facilities team is partnering with Northern Light Health members around the state to develop long term plans both for safe testing in the future, and to repurpose the testing structures for future use.

Northern Light Medical Group

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THE FOUNDAT ION OF OUR COMMUNI TY

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Neighbors Helping Neighbors A lot has changed since March 2020 - a global pandemic will do that. However, one thing never wavered – Mainers’ commitment to their communities. As news spread about the effect COVID-19 was having on our healthcare system, the Northern Light Health Foundation’s phones started ringing and email messages poured in. Remarkable people, organizations, community groups, small businesses and corporations reached out asking how they could help to support our healthcare heroes. Our first responders, front-line healthcare workers, and patients were humbled by the donations of meals, snacks, personal protective equipment, hand-sewn masks, monetary gifts, and other important items. Their kindness lifted spirits and added a Banking on the Vaccine Recently, Bangor Savings Bank donated $45,000 to provide staff and volunteers working at the Northern Light Health vaccine clinics with snacks and beverages during their shifts. Additionally, Bangor Savings Bank employees donated their time to volunteer as teams at the Cross Insurance Center mass vaccination site.

The Scouting Difference The Girl Scouts of Maine weren’t able to host cookie sales at various businesses in 2020 like they traditionally do. The cookies that they were kind enough to share with non-profits were the extra boxes they order for these supplemental sales. Knowing that the cookies expire, they chose to help spread cheer by donating them to non-profits in Maine, including Northern Light Health. They delivered more than 8400 boxes of cookies to Northern Light Eastern Maine Medical Center and Northern Light Mercy Hospital, and the teams at the Foundation made sure to donate boxes to employees at all member organizations.

bright spot, even on the darkest of days. Cash gifts received: More than $150,000 Gifts in Kind: Priceless (but valued at more than $300,000)

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WHAT WE LEARNED

“The COVID-19 pandemic has reinforced the fact that rural hospitals are vital to the communities they serve which is why Northern Light Health is planning major upgrades for two century-old hospital buildings in Hancock and Piscataquis counties. The new facilities will include telehealth services, 24/7 emergency care, and lab and imaging services.” News Center Maine “Northern Light has turned Bangor’s Cross Center into a well-oiled vaccination machine.” David Marino, Jr. Bangor Daily News

“I want to once more thank the Northern Light Health organization for the work they are doing not just at the Cross Center but at numerous vaccine clinic locations across the state.” Tim Forsman Fairfield

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A Well-Oiled Machine With all the bad that the COVID-19 pandemic brought about, there have been some amazing discoveries and advances – globally and within Northern Light Health. Now, more than ever, Northern Light Health is experiencing and relying on what we call systemness, recognizing that all of our member organizations have more in common than they realized before. This recognition has allowed quick response – the development of vaccination scheduling solutions and turnkey approaches for administering thousands of tests and vaccines; systemwide policies, developed by leaders from across the state to ensure the health, safety, and success of staff and patients; and a feeling of community among co-workers who, miles away, work together every day to ensure that care is accessible for all. Population health management, as a concept, can be hard to understand, but the unity and hard work that stave off the spread of COVID-19 has been a visible representation of how every step, big and small, we take can improve the health of our patients, friends, and ourselves, and that Northern Light Health will be here for the people of Maine – guiding them through the care experience.

Maine Governor Janet Mills tours the Cross Insurance Center mass vaccination site with Maine Center for Disease Control Director Nirav Shah, MD.

Rick Barry, clinic incident commander and vice president of nursing and patient care services at Northern Light Inland Hospital tells CEO Tim Dentry about the amazing staff and volunteers at the Fairfield Vaccine Clinic.

Northern Light Health communications specialist Bob Potts records video detailing what to expect as a visitor to the Cross Insurance Center mass vaccination site in Bangor.

Northern Light Eastern Maine Medical Center Pharmacist Generalist Ifeoma Ifeji measures a dose of the COVID-19 vaccine at the Cross Insurance Center mass vaccination site.

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Northern Light Health Acadia Hospital AR Gould Hospital Beacon Health Blue Hill Hospital CA Dean Hospital Eastern Maine Medical Center Home Care & Hospice Inland Hospital Maine Coast Hospital

Mayo Hospital Mercy Hospital Northern Light Health Foundation Northern Light Laboratory Northern Light Medical Transport & Emergency Care

Northern Light Pharmacy Sebasticook Valley Hospital

northernlighthealth.org

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