<Donna> We're taking care of human life.

What an honor.

It's a calling.

It's not just a job.

<Bruce> I think we're stronger together than we are apart, when it comes to policy, strategy, to solving problems.

<Nurse> So, we're going to take your blood pressure <John> We've got more involved in quality improvement and quality concerns and it's a big part of our mission S.C.H.A today.

<James Clyburn> They're professionals.

They study the issues.

They help frame the science.

They help inform the public officials.

<Gayle> They're always going to be new challenges.

We're going to rely on S.C.H.A to help continue helping with that.

<Thorton Kirby> We don't make the healthcare.

We make the health care better.

♪ >> The hospital association in South Carolina is the community of hospitals and the care givers in those hospitals, and our goal is to build a better state of health in South Carolina.

>> The hospital association of course, has always been a critical place where the leaders of the hospitals around the state have met and collaborated.

This hospital association is somewhat unique in that - It always was, even when I came here in the early 70s, part of it is because of the Duke Endowment.

The Duke Endowment in its original trust agreement had money that came to hospitals in North and South Carolina, because of a lot of the support that the Duke Endowment gave us, also gave us a strong incentive to work together.

>> I'd say the hospital association was originally conceived as a way for hospitals to get together and share their challenges and their opportunities and priorities and try to make a concerted voice, a collective voice for their needs and their needs to their patients and their caregivers in their communities... so that's what it's been throughout its history.

Most of that time through say 2005, most of that life of the hospital association and in most states has been about legislative and regulatory advocacy, going to the state house, going to the regulatory agencies going to Congress and articulating the needs of the hospital community, so that they can better serve patients in their various communities.

That's what it has really been about.

<Bruce Bailey>When you have an organization like the hospital association that is there to represent the needs of, the interests of you know the healthcare delivery system that's helpful.

Right?

I think we're stronger together than we are apart when it comes to policy, strategy, solving problems.

>> We might collaborate on things like emergency preparedness or quality initiatives or patient safety initiatives.

When I go to Columbia to a meeting with the South Carolina Hospital Association, it's not uncommon for me to know most of the people in the room, most of the other health executives across the state, and I think an association that's doing a really good job has helped create a network of leaders in this case, where they can collaborate with one another, share information, share best practices and of course advocate on behalf of the industry.

That's important in today's society, as well.

So, SCHA accomplishes all those things.

<Thorton> At about 2005, there was a national movement toward more quality and safety, and so we, since 2005, we've also been in the business of quality improvement, performance improvement, safety for patients, trying to eliminate unnecessary or preventable harm wherever possible.

So, now we have two hemispheres of our brain, not just advocacy but also quality improvement, performance improvement for hospitals.

♪ >> The hospitals in the 19th century are... interesting institution.

It's a combination of confinement and moving the sick off the street and isolating them.

If you are sick, going to the hospital is not really the place you want to be, because the number of people that came out of the hospital better was a pretty small number.

In fact, the mortality rate was quite high and really you didn't go to the hospital.

You weren't treated at a hospital, unless you were a person with limited economic means and low income.

If you had any kind of economic status the doctor came to you.

So, your treatment was in the home, even if you had to have surgery, the surgery would be done in home.

It wasn't at a hospital so that doesn't change until the very late 19th century and into the 20th century.

The funding of the Medical Society of South Carolina is really a group, mostly based in Charleston.

Initially, a group of physicians who feel that they need to really create a professional community one in which they work together to do things like even establish a common fees and also to really learn from each other, help support each other and provide a service to the community and then they also become very strong advocates of education.

So, one of the things they do is they create a library, reference library of the newest research, which eventually becomes the core of our collection... and then they're also becoming strong advocates for a medical school in Charleston, or at least in the South.

♪ >> MUSC or the Medical College of South Carolina as it was known in 1824 was established by the Medical Society of South Carolina, the first building was on Queen Street here in Charleston.

The student enrollment fluctuated greatly There was a period in 1872 when...we only had two graduates, and the school to their credit, to the medical society, they were determined to keep the school open, because they really wanted to educate Southern men here in the South.

So, the dean at the time, Robert Wilson, he kind of took that as a challenge of okay we're going to save the school.

So, he went to the state legislature and the governor at the time, Coleman Blease and worked with them to gift the school with a gift to the state.

So that's how we became a state institution.

The Medical University of South Carolina is probably one of the most important institutions in the state since its founding in 1824 because it has educated hundreds of thousands of physicians, nurses, dentists.

You name it, across the state.

It was the only game in town, until the 1970s when the medical school at the University of South Carolina opened.

<John> Back in the turn of the century in 1900 and ...you got to remember we were still recovering from the Civil War in the south...so they would they have been some hospitals that were related to the war effort that took care of war veterans and things of that nature, but there weren't many around the rest of the state.

Charleston was probably the only one that had much of a hospital or healthcare system.

Of course healthcare in those days, we didn't have all the drugs and all the surgical procedures and things that we have today and so a lot of hospitals were places where people went to die.

They weren't necessarily places where people went to get cured.

Anmed Health, which was originally called the Anderson County Hospital Association and was not really connected to the county per se.

It's never been a governmental hospital, but we opened our doors on April the 20th, 1908 thanks to the effort of Virginia Kramer Gilmer who came from Charleston and had a difficult time in childbirth and decided that she wanted to build a hospital here and so she was successful in doing that, we were incorporated on October the 12th of 1906 and as I said opened our doors on April the 20th, 1908.

The hospital at that time grew and today we have four hospitals in the system, including AnMed health Medical Center and AnMed Women's and Children's hospital and AnMed health rehabilitation hospital AnMed Health Cannon Memorial in Pickens.

You can tell that a lot has changed nearly 600 beds in the system to this day and we serve a major population in Northern Georgia and this part of South Carolina.

<Brian> Well, so religion and religious orders really provided some commitment to serving lower income destitute citizens in communities and you can follow that all the way back to the Middle Ages when convents are establishing hospitals.

They are definitely involved in doing that in the 19th century and into the 20th century and the most prominent example of course is St Francis Xavier in Charleston, the most prominent example.

They built the infirmary in 1882.

They expanded in the 1890s They had a new building in the 1920s and they're constantly growing and developing and playing a role and their service of course is doing God's work in the community.

>> The bishop of Charleston bought the pay hospital from the Salvation Army, because he wanted to have a faith based hospital in the upstate, and then he invited the Franciscan sisters of the poor to come and be the sponsors of the hospital.

The principles and values that guide our health system today are pretty much the same as they were when we first started.

It's always just take care of the poor and the underserved and we would never turn any patient away that just because he didn't have money, for example.

So, it means that we go to great means to try to help people who are poor and needy, while still it's a real balancing act today.

...it always was.

I think today in our society, health care is much more challenging.

[coughing] <Brian> The flu pandemic started in 1918 was a surprise in general to the medical world.

There had been a lot of research and discovery about bacteria and even viruses, and so ...there's this kind of confidence to some degree that the medical world has this handle on illness and then the pandemic hits and there's no understanding of what this is and where it comes from, and not prepared to deal with the large number of sick people.

<John> With the flu pandemic of 1918, hospitals if you can just try to imagine what things were in those days, you got to remember we didn't have any of the technology that we have today.

We didn't have any of the drugs that we have today.

<Brian> We're talking about I mean the ranges of those who died, the numbers are quite varied.

It ranges from 50 million to 100 million worldwide and so it's quite devastating to the medical world and it shakes things up.

So understandably there are going to be changes that come out of that.

There's going to be a renewed commitment to research.

There's going to be renewed commitment to public health services.

<Thorton> In the early 1900s, there wasn't a lot of organized hospital care.

That began to change after the Spanish Influenza of 1918. there was so much widespread need for public health in that first global pandemic that we now see echoes of.

the 1918 time period in the subsequent years led to a lot more organization of hospitals as business units and as communities of care givers.

So hospitals as they became more sophisticated they begin to get together and share their priorities and their challenges and opportunities.

♪ We still didn't see what we think of as a modern healthcare system until after the second World War.

This nation realized it needed more hospitals.

It didn't have enough hospitals.

So, we as a country passed a law in Congress called the Hill Burton Act and that gave money to communities all across the country for the establishment of county level hospitals and so you saw many, many small hospitals built all across this country as a result of the Hill Burton Act and that gave a real infrastructure or community of hospitals.

<Donna> McLeod Health is especially proud of its 115 year heritage founded by Dr. F.H.

McLeod.

We're celebrating our 115 years, this year, but here at McLeod Regional, because the founding was here in Florence, we have a mission gallery.

It's quite fascinating to go into the mission gallery because you find some of the ledgers of the hospital bills and it'll be two dollars and three dollars, but you watch that progression of the growth, the growth that was about serving this region.

It helps you to understand where we came from and where we're going.

So, for McLeod Health it's important to have those our small rural health care systems, because it's part of our mission.

Our mission is to this region.

One of the things I like to say a lot is we're local people caring for local people.

It's difficult however to have the small rural hospitals, because on their own, they're not really financially viable in most cases, because there just isn't enough volume to draw the viability that you would need, but yet there is volume that would physically suffer if you weren't in those regions.

The things that become really critical in rural communities are emergency care.

So, it's so critical for the livelihood of those communities, literally, the human lives in those communities.

It also matters a lot to industry, because quite frankly, if you've lost your health care anchor, it's so difficult for those communities to recruit people that want to live in those communities.

So, it also fits with the mission of McLeod Health.

Our mission is to improve that health and well being of the region that we serve.

So, it all links back to us from McLeod, from a mission standpoint of how we need to do the work here.

♪ <Bruce> We've grown a lot over the years and we got a lot going on in Horry County and the parts north, but you know at Georgetown Memorial, where it all began and we don't ever forget that, that is where it began.

We have a history wall that kind of traces our path from the 1940s and 50s when there was no hospital in Georgetown County.

The closest was Charleston or Florence when those that came together to find the money to do that and then... the Yawkey Foundation.

So,the interesting thing I find about this community is the number of very well to do industrialists that found Georgetown County to be either a summer or winter retreat.

Right?

Tom Yawkey would vacation here on South Island, preserve down here with them so, you know, the community organizers went to some of these folks and asked for money and got it, right.

So, that kind of starts Georgetown Memorial Hospital and then we just kind of trace the progress of the hospital over time, you know, to what we are today.

then re-branded the title and the Waccammaw hospital over here.

So, that's good.

I mean it's good to be able to remember your history, right.

It's important that remember where you came from and why you got started to begin with.

Right?

♪ >> Health care is a very labor intensive business, and we rely on a lot of specialized individuals, and we have to recruit them.

...I would say probably today is one of the biggest challenges in our more rural facility...so the hospital association has taken a really important role in advocacy related to workforce development.

>> Oh, elliptical.

<Patient> Yeah.

>> Yeah, okay.

Gotcha.

♪ >> The V.A.

opened in 1966.

It's been a story of growth since then.

You know Charleston, you know we are growing rapidly.

I think this whole area is growing in terms of overall population.

Veteran growth has been a tremendous relief for many, many years, but specifically over the last 15 years or so we've built a lot of additional space here and it really expanded our operation.

We've got our main facility here in Charleston and we cover the entire coast from Myrtle Beach down to Savannah, Georgia so several large facilities.

We've got our Columbia VA, and they've got clinics more in the upstate.

The VA, largest health care organization in the country integrated health care system 170 hospitals.

Our mission is really four fold so we provide clinical care, provide education to medical professionals, provide research and had a lot of discoveries over the years and then emergency preparedness were really the back up in terms of natural emergencies other things that come up that we can help coordinate and help our partners I knew South Carolina is a state the cares about veterans.

They are very patriotic what our veterans have done.

I've always said take care of veterans is the best thing I could ever have hoped to do.

It's been an incredible privilege to do that, our mission incredible thing but it's something that we can't do without other partners I think the hospital association really gives us that connector that allows us to work with everybody to fill the most incredible mission we could ask for and that's taking care of veterans.

>> You know Jim Crow hospitals were the thing in the South, most black communities did not have a hospital.

Most African Americans in the south particularly in areas, you know, where it's rural and you have one main hospital, that may or may not serve black patients, black members of the community and you have a number of cities throughout the south that had hospitals that would certain white patients only and Black patients had to go to a hospital that might've been 15 miles down the road in order to get healthcare.

>> Physicians offices were frequently also segregated.

You could see the White waiting room on the other side.

We had benches and wooden chairs.

They had couches and padded chairs.

The lady who was the receptionist, took care of everybody else before she took care of us, and it was those little indignities that Black patients and Black physicians suffered that caused the creation of not only Black medical associations, but also Black hospitals.

The Palmetto Medical Association was formed in 1896.

Five physicians decided that they wanted to get away from the indignities that they had to suffer.

They were refused membership in the white medical societies and the South Carolina Medical Association, so they created their own what they called the Palmetto Medical Associates, actually it was the Palmetto State Medical Association, which eventually evolved into the Palmetto Medical Dental and Pharmaceutical Association and it has been in existence and very active from 1896. until this very day.

<James Clyburn> I was 6 years old.

I was in an automobile accident, run over by an automobile, and had to go to the hospital.

In fact, I had my sixth birthday in the hospital and I remember vividly the unequal treatment, one Black nurse for all the Black folks that were around that we all knew, that one nurse.

So, that's the history.

You can't change the history.

What you can do is work as hard as possible to overcome it and some of us have undertaken to do that.

<Cecil Williams> It was a time in America when in the mid 1960s, the Civil Rights Acts by President Johnson.

Things had opened up and improved for African Americans, but still yet it was a long battle in opening up other opportunities.

<O.

Jennifer> In 1969, there was a hospital worker strike that involved hundreds of workers, mostly female and all Black at Medical College hospital in Charleston, South Carolina, and the moment was sparked when five black hospital workers were fired unjustly in late 1967.

We know that in 68' Dr. King was assassinated, so these workers are already organized or organizing when Dr King is assassinated.

So, they are sort of feeling the brunt of that, but also feeling emboldened by the fact, right, that the movement is still in full swing, and one of our great leaders has been taken from us and so for many of those workers they sort of felt you know fired up, in honor of him in many ways.

So, it becomes not just a local movement, it gives this moment national attention.

In March, there are 12 workers that are fired.

Once they're fired, and this is around the 17th of March, three days later, the strike starts.

>> In 1969, Jet magazine from which I worked for mostly from about 14 years old, submitting my first pictures and at 18, actually becoming employed by them, that was my assignment to go to Charleston, where this event had emerged.

There's a picture I took by standing on top of a car by the way, in downtown Charleston.

This is Mrs. King in the front, leading the movement leaders.

<O.

Jennifer> Dr King's widow, Coretta Scott King comes into Charleston, again bringing national attention to this moment.

She is still very much a media presence.

She's still very much an important and viable part of the Civil Rights Movement.

<Cecil> This is another picture in the streets of Charleston, and important about this is, this is Mrs King who's protected by SLED.

It was a time that tensions are running high and security again is very tensioned.

So when a car backfires, you'll see Mrs King, immediately turning to her right because again it sounded like a gun fire.

I remembered that very moment.

These were the events of that time in history, 1969 where again just human dignity and people just wanting the right thing was really coming to a head.

Just trying to get equal wages.

This was so unfortunate this had to happen, but thankfully today we have better hospitals.

We have better hospital administrators.

Our healthcare system is very, very important today and with us undergoing what has happened with the COVID, we really are very grateful that medical science has enabled us to do this and as we reflect back over the time in those days again I think we appreciate life even more so.

<O.

Jennifer> The strike is ultimately resolved when a moment like this unfolds, what does it mean and how does the meaning change for different people involved?

So for the workers, this is their blood, sweat and tears.

This is the survival of their family.

This is their career.

This is their livelihood for people in leadership in terms of the state government, the governor, the mayor, This is a blemish for them coming out of this moment.

This is impeding, you know, tourist activities impeding economy.

It's a problem.

Right.

We got to figure out how to resolve it as quickly and as effectively as possible.

For the hospital administrators it's causing an issue in terms of patient care, but it's also a threat to our existence, because if they pull federal funding, what next?

>> It's incumbent upon us to talk about these things, and that's part of MUSC's sort of ugly history.

I mean that you can walk through our hallways downstairs on the first floor and you can see some of the artwork that represents, you know, what was going on with the Civil Rights movement and how it impacted what was going on this campus, and I think what's important now is that we're talking about it.

<Gallman> African Americans had to create their own hospitals and their medical societies because we were not admitted into mainstream medical schools.

We had to create our own medical schools.

So, those days actually brought out the genius in people of African origin because it was about more than survival.

It was about thrival, I like to say.

...we did indeed thrive.

<James Clyburn> I do remember Lyndon Johnson's Great Society programs.

A significant part of the Great Society programs, of course, had to deal with healthcare, medicaid, medicare.

These were Great Society programs that still exist today.

I smile when I hear people talk about how they failed, that Great Society was a big failure, but nothing could be further from the truth.

<Thorton> Medicare, generally speaking, covers people from 65 until the end of their lives.

At that time, life expectancy for a man was about 67 and a half.

So, it was a relatively short commitment by the federal government and Medicaid is built to cover children, pregnant women and disabled persons.

Once the government decided to connect Medicare and Medicaid, the government began making regulations for how those would work and that brought us to the modern era of government regulations, with that naturally comes a need for hospitals to talk to government and talk to regulators and say that idea is not well crafted.

We think it should be more like this.

We recognize what you're trying to do, but let's do it this way instead of the way you proposed or to go and say we have a distinct need and we need government to help address it.

So, the 1960s is really when an association like this came into its own and really began to have professional staff and needed the everyday constant dialogue with the government about healthcare.

♪ Several things have changed in my tenure.

So, I started in 2005 That is when the hospitals began working together, collectively through this association to improve quality of care.

Prior to that hospitals didn't come to the association to find out how to make their care better.

That's not what they look to the association for, and we still don't have resident expertise.

We're not out telling physicians how to care for their patients.

What we are good at is convening hospitals and saying, you know all of us could do a better job with heart attack care or surgical safety.

Let's compare notes.

Let's see who's doing it the best.

Everybody tell their breakthroughs and let's share those and you can all take them back to your own communities.

That is where we really made a difference, convening, collaborating.

That has been a real change, a sea change in what this association does.

<John> I think because of Thornton's leadership at the hospital association.

We've gotten more involved in quality improvement, and quality concerns and it's a big part of our mission at S.C.H.A today.

>> There has been a constant commitment by physicians and hospital leaders since day one to try and improve care for patients.

What we've learned in this era of big data and new data is you can see patterns and trends in patient care that no individual physician could see by observing one patient at a time.

So, when national groups began studying what works best for patients, we begin to see patterns and we begin to see the best practices who has the best outcomes for example for heart attack care and what do they do?

Why are their outcomes better?

Let's study that and then let's bring that back and all adopt the same common standards or best practices for treating a heart attack.

That's the work that began in 2005.

Our state hospital community joined in that national effort.

We focused on heart attack care.

We started the average time from the door of the hospital to the procedure was about 93 minutes and the national standard at that time was 90 minutes.

That's what we were shooting for.

When we did this statewide and rebuilt the care and started from the ground up and did all the same things on all the ambulances with all the E.M.S.

crews and emergency departments and cardiologists, we dropped that time to about 46 minutes, statewide.

So, it doesn't matter where you are in the state.

All the state EMS crews, all the hospitals are going to use the same standards and we're going to get you to the right place for a heart attack.

That was really revolutionary.

We had not ever done anything like that before.

<Caroline> My relationship with MUSC began as the mother of a pediatric trauma patient.

So, when my youngest son was 11 months old, he was struck by a car in our driveway, and so we were rushed immediately to the nearest emergency room closest to my home where they could do absolutely nothing, and then he was transported downtown to MUSC, Children's Hospital ER where the temper changed very quickly.

He was triaged and intubated and moved upstairs to the pediatric ICU very, very quickly.

He presented with injuries that were critical in nature that they told us that we should probably hope for the best, but plan for the worst.

So, he had bi-frontal contusions and intracranial hemorrhage and he was not expected to survive, but he did survive.

It's sort of a miraculous story.

The reason I'm here today is because I am paying it forward or giving back, whichever way you prefer to put it.

I am privileged to work in the shadow of my heroes.

I always define patient and family centered care as does the institute for patient and family centered care, which is a nonprofit organization which is where I first started learning about this work, but it's about creating meaningful and intentional partnerships with patients and families.

So, those partnerships exist between patients, their families and our providers.

It's about working with patients and families rather than always doing too and for them.

What I found when we were here is that you know there are pockets of wonderful in our health system and I don't know that this makes us any different than any other hospital but there are pockets of wonderful, but do those pockets translate across the healthcare system from inpatient to outpatient to every single caregiver that is within our system?

...so teaching hospitals how to create these councils how ... then how to strengthen them and sustain them and make sure they're involved in the quality improvement work in hospitals, is really - it's what I'm passionate about and what we are working and striving toward here everyday at MUSC.

♪ <Thorton> One of the trends in healthcare today is consolidation.

We've seen that not just in the hospital side, not just in the physician side but in the insurance side, as well.

<Rick Toomey> My father was Robert E. Toomey and dad had an impact in Greenville and also South Carolina, but in Greenville.

As Greenville, saw it was an opportunity.

Greenville was growing.

Interstate 85 connecting Charlotte to Atlanta.

Greenville was in a wonderful location.

So, as Greenville grew, dad strategically placed hospitals and facilities to match that growth in the different communities of Greenville.

So, his impact was far reaching in the sense of not only developing the hospital, but recruiting physicians and expanding the medical staff base, the specialists that came to Greenville and connecting Greenville with the University of South Carolina and connecting Greenville with Clemson University for educational purposes.

So, in the systems development, there was concepts.

A horizontal system would be all of the same hospitals, either a system of all acute care, all nursing homes being managed collectively.

Dad took that to a different level to be vertically integrated and that concept had not only an acute care hospital, but others like rehab, mental health, nursing homes, under one management team for the efficiencies that would give to each of those organizations and then collectively, the purchasing power of having a consolidated entity helped the efficiencies and the cost effectiveness of the system.

In recognition of dad's career, many of his friends, colleagues decided in 1993 to nominate dad to the Health Care Hall of Fame.

Frank Pinkney who succeeded dad after Jack's group sent one of the nomination letters and in it he said, "Perhaps Bob Toomey's most far reaching contribution was the development and early implementation of the concept of multi hospital organizations, a chain of hospitals and that embrace that he really became the father of multi hospital systems and when he retired from Greenville, he actually was hired by the American Hospital Association to run their multi hospital systems organization that had offices in Greenville, Washington and Chicago.

<Thorton> When I came about 2005 our state did not have a lot of large systems.

Most of our hospitals were still independent, meaning one to two hospitals in their system.

...since that time, the trend nationwide has been toward larger systems.

Now, why is that?

It is primarily, because the cost of doing business as a hospital is increasing all the time.

The electronic medical records you know, we're way behind the banking system.

We don't have the electronic interoperability that the banking system does.

All of us take for granted now, that we can go to any ATM in the world and get money out and it comes out of our account.

It doesn't have to be our bank.

We're a long way from that in health care but we're definitely moving in that direction with the electronic medical records, but those are very expensive to acquire and to implement and to use and small hospitals just do not have the capital to do that.

So, they become part of a larger system that can do it.

>> Late in 1995, early 96 Kester Freeman who is the CEO at Richland Memorial Hospital, came to see me in my office.

We began to talk about what was going on in the environment and he made a statement to me.

He said Chuck, "I hope Baptist will not sell out to the for-profits", and I looked him in the eye very quickly and I said, "Kester, the Baptist hospital will spend its last nickel "to remain not for profit.

Mission is everything to us, "and we want to remain locally controlled, "locally owned."

That sparked a lengthy conversation that day about the two organizations exploring the possibility of coming together.

We were able to announce in 1998 our intentions to form a system and bring together Baptist and Richland and we thought we'd adopted the theme "Better Together".

Mr Mike Riordan was the CEO of the Greenville Health System, but we had a mutual interest in the up state, known as the Baptist Medical Center Easley.

That was a hospital that we owned and operated.

So, Mike and I explored the possibility of well maybe this is an opportunity for us to do something together and so we became official in 2017.

We started as South Carolina health company or health care company, and quickly changed that to PRISMA Health, so we would be unifying the name and identity, but when you're fundamental commitment is to improve the health of the citizens of South Carolina then size becomes important, because you have the resources.

You have the manpower.

You have the expertise that you can channel and together and put it together, all moving towards that common good of improving health, as opposed to saying, "Oh wow!

We're big for big's sake!"

And we've got you know money flowing in and boy it's been a great day.

It's only great if you're improving the health of the communities, and serving the needs of the community and I'm talking about all people, regardless of ability to pay and that's a powerful thing that's what excites an executive.

That's what excites a management team.

That's what excites a medical staff.

That's what excites employees when they wake up every morning to go to work.

They know they have the opportunity to make a difference in the lives of other people through service.

<Bruce Bailey> You've seen Prisma get formed between Greenville Health System and Palmetto Health It's a really large health system in South Carolina.

MUSC, the leading academic medical centers are now a lot more progressive in terms of creating their own network of hospitals.

So, something you'll see some consolidation, I think that trend will probably continue, probably a...good trend.

You need some size and scale to deal with the issues that health care has in front of it right now, but that'll be a challenge to the association.

Right?

- as the industry consolidates.

So that'll be something for them to have to deal with.

Obviously, there's tremendous growth in Horry County.

I think, yesterday Myrtle Beach is the fastest growing city in the country, on a percentage growth basis and Horry County is the second fastest growing county in the country.

So, tremendous growth up there, right?

We have to meet the needs of that community and all the growth that's coming there and there's opportunities there to bring new services to the community.

So, I think that'll be a big challenge going forward for the health care industry.

It's how do you continue to maintain access to needed health care in some of the more rural parts of South Carolina.

♪ >> When I think about this pandemic in our history and our birthday coming in the midst of a pandemic, I can't help but think about the circle of life in this.

I hear the Elton John song in the background, but we did begin our history right on the heels of a global pandemic and here we are, we've made plans to celebrate our one hundredth year and those plans were interrupted by the next global pandemic.

Well, I don't think any of us expected this.

It has been a very interesting time for us as an association because we, had hoped to spend a lot of time talking to our members and celebrating.

What we actually did was increase our relevance to them by helping them in one of the most challenging periods of their existence, as well.

...so we were able to help them in a time of need.

>> When the Pfizer vaccine came out and needed ultra cold storage to have it in the community, well that was hospitals, right?

So now, by default about the mere fact that vaccine required that kind of storage, we're now front and center in the effort to vaccinate folks.

One of the great things that the association did back in 2011 to 2012 was work with the Duke Endowment in Charlotte, North Carolina to bring money into the state to help health systems who wanted to establish what we call back then access health networks.

So, it was an effort to help the uninsured, underinsured get access to care.

Help them navigate the healthcare system so we were meeting from 2012 until 2020 to meet the needs of the less fortunate in our community that had already done tremendous work, right?

The pandemic hits, guess who we leaned on to help us reach out to the marginalized communities to the rural communities?

How do we meet their health education needs on COVID.

So that network that SCHA helped create across the state in 2012 turned out to be one of the greatest assets that we had in 2020 when a pandemic hits.

<Dr.

Rick> Health care continues to be a very complex world and the pandemic just kind of reinforced how complex it can be, and when you're dealing with complex issues and complex systems it's good to have an organization that can help make those connections, that can help coordinate education and active learning and monitor the work they've done and look at the data at both the community and state level and be able to connect with the public sector.

The public and private health care sector more than ever need to be active partners, and that's one of the advantages we've seen during this pandemic.

I think that South Carolina compared to a lot of other states.

We already had a very good working relationship between public health and private health care and often, you know, in the past, it was thought about those are two totally different worlds, and the reality is, if we don't work well together, we're not going to be successful in dealing with any major public health issue, including a pandemic.

I think that's an example of where a hospital association is doing the work like it should, it's helping to drive those kinds of relationships that are critical for us to do the best we can for the residents of our state.

<Thorton> Now we have much more sophistication, much more technology, much more pharmacology than we ever did and our life spans are much longer.

So, the cost of healthcare is much greater.

So, now when we look at the health care system, I hear many people say our healthcare system is broken.

Now, I share their sentiment that we need to change things about it, but I don't believe it's broken.

I believe it is doing what it was built to do, and that is to intervene and to treat acute illnesses regardless of cost.

That's we built it to do.

Unfortunately we can't afford that.

Now, we need to do more work in preventive care and managing chronic diseases and managing costs.

So, that has become one of the primary goals of lawmakers and regulators and healthcare leaders is how do we do a better job of keeping people healthy, so they don't need such acute care and it relieves the burden of costs that is associated with letting a disease progress to a very, very bad state and then you have to spend a lot of money to intervene.

So, where are we now?

We are trying to keep people healthier and we have many new technologies, telehealth is one of the latest tools that is really come into its own during the pandemic, the more recent pandemic of COVID-19.

We've seen more and more people use their cell phone or their computer to interact with a care giver and the public adoption has been very strong and comfortable.

<Nurse> Okay, sweet pea.

<Boy> That tickles.

>> Alright.

<Doctor> Good to see you.

<Boy> You too.

<Dr.

Rick> The platforms used for doing it and the equipment allow to be able to have the level of resolution to be able to do the various ranges of telehealth services, even examinations with some of the technology available, to plug and play, basically.

The big challenge is still though is the fact that a lot of those communities where they may have the iPad or the computer and they may have practitioners who are willing to provide the services, you do have to have broadband access.

That's why that's become one of the big focus areas down in our state is that you have to have adequate Internet access to be able to get the signal, but when you have broadband access, it's amazing what you can do.

You can do eye, ear, nose and throat exams.

You could do fairly complete cardiac exams, and lung exams.

You could do wonderful consultations around behavior health type services.

We've got a number of hospitals that take advantage of critical care physicians providing care for their intensive care unit patients, because they can see the patient with someone guiding it, they could do an exam.

They could see all of the monitors and be right there anytime you need them.

So, it's kind of like having that available 24/7.

<James Clyburn> When I got elected to Congress, I took to Congress those experiences that I had.

and when it came to the Affordable Care Act, that's when I began to work very closely with the South Carolina Hospital Association.

I'm trying to get that act across the finish line, but we got it done, much to the surprise of a lot of people, the program or the concept, of universal access to healthcare.

The South Cross Hospital Association, they're professionals.

They studied the issues, and they helped frame the science, they help inform the public officials and so I always say that all of us have roles to play, and if we all play our roles efficiently and effectively and equitably we'll get the job done.

I think they play a very effective role.

I wouldn't be participating in this program, if I didn't, I do think they're very effective.

<Charles> The hospital association has many roles to play I couldn't be prouder of what they've been able to accomplish and are accomplishing, today.

I'm very optimistic about the future of healthcare in South Carolina.

I'm very supportive and appreciative of the role that the hospital association plays, but forever indebted to the employees, the caretakers day in and day out that put their lives on the line for people that they may not even know what a tremendous opportunity, we have to thank them appropriately.

They're real heroes.

<Donna> The thing I'm most proud of as the leader of the board for the South Carolina Hospital Association now for the last 18 months is the camaraderie that has been developed amongst the healthcare systems.

I think what changed during the pandemic we were thrown in together to develop true authentic personal relationships with each other as leaders of healthcare systems with the hospitals and SCHA with the governor's office, with DHEC for taking care of human life.

What an honor to be invited into the lives of our patients and they entrust us to care for them.

It's just a calling.

It's not just a job.

<Rick> The legacy of the South Carolina Hospital Association I would say is their continued focus on helping hospitals serve their community.

It is just the best of the best have been involved with health care in South Carolina and it's just an honor that I've been able to be part of that and be part of my dad's legacy of being involved in health care and trying to improve the health of any community that we serve.

>> We don't make the healthcare.

We make health care better.

That's how I've always thought of it.

Our goal is not to deliver healthcare.

Our goal is to help those hospitals do it better.

Is our readiness for a hurricane better?

Is our readiness for a pandemic better?

Are we better it dispensing vaccines than we were before?

Are we better at keeping people healthy who have diabetes, than we were before.

Our job is not to care for the community.

Our job is to make sure our hospitals are equipped to give the very best care in the world and I think in many instances, South Carolina's healthcare is as good as anywhere you're going to find in the world.

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