The New Black River Medical Center

The new MUSC Health Black River Medical Center, opening in early 2023, is bringing high-quality, innovative health care to one of the more rural areas of South Carolina. Jay Hinesley, CEO of MUSC Health Florence Division, and Allen Abernathy, CEO of Williamsburg Regional Hospital, share details about the new MUSC Health Black River Medical Center in Cades, serving Williamsburg and Lower Florence counties.

“This is what MUSC does well: it fills the gaps that other communities and other health systems perhaps can't fill. As the struggles of rural health care continue to rise, MUSC Health has developed a model that can fill the void.”
– Jay Hinesley, CEO, MUSC Health Florence Division

Topics Covered in This Show

• As the struggles of bringing high quality care to rural communities continues to rise, MUSC Health executives say they’re developing a model, such as the new MUSC Health Black River Medical Center, that can help fill the void.
• The MUSC Health Black River Medical Center is named after the Black River that courses through many of the communities this hospital will serve. With a focus on community, the hospital establishes common ground between the surrounding neighborhoods.
• Built for the future, the design of Black River Medical Center outpaces older hospitals in the state that were designed around health care that existed 50 years ago based on the Hill Burton Act.
• As a 64,000 square foot facility, Black River Medical Center is unlike any other medical center in rural South Carolina. It also offers 3D mammography and MRI machines, not previously available in the area.
• The hospital offers robust technology for various forms of telehealth, bringing in specialists to the community that would otherwise be unavailable. This is especially important considering a possible shortage of providers in the future for health care at large.
• While Black River will primarily care for people with conditions that can be treated with medication (as opposed to surgery), patients can still receive pre- and -post surgical treatments as well as necessary diagnostics for surgery at this location.
• The Black River Medical Center was built during the pandemic, and was extremely collaborative in design. Health care leaders from Williamsburg, Lake City, Florence and Charleston collaborated in planning its features. The team also included patient advocates who helped imagine a hospital that could truly meet the needs of its patients, especially regarding treatment that is most common in rural areas, such as emergency care.

Show Transcript

Erin Spain, M.S. [00:00:04] Welcome to Advance with MUSC Health. I'm your host, Erin Spain. This show's mission is to help you find ways to preserve and optimize your health and get the care you need to live well. A new MUSC Health medical center opening in early 2023 is bringing high-quality, innovative health care to one of the more rural areas of South Carolina. Here with details about the new MUSC Health Black River Medical Center in Cades, serving Williamsburg and Lower Florence counties, are Jay Hinesley, CEO of the MUSC Health Florence Division, and Allen Abernathy, CEO of the Williamsburg Regional Hospital. Jay, share with me the genesis of MUSC Health black River Medical Center. Why is a hospital such as this so needed in this area of the state? 

Jay Hinesley [00:00:57] This is what MUSC does well — is fill the gaps that other communities and other health systems perhaps can't fill. And when you look at rural health care across the United States, hospitals are closing. Rural hospitals are having a tremendous difficulty staying open, recruiting personnel, recruiting physicians. And MUSC Health, as a very large and innovative health system, has the tools and resources to take care of the community a little differently. Both facilities in the area — Lake City Community Hospital and Williamsburg Regional — have had financial troubles the last several years. Williamsburg Regional was severely impacted by the 2015 rains that ultimately impacted their building to a point they could not inhabit the hospital. And so, as the struggles of rural health care continue to rise, MUSC Health developed a model that could fill the void. We're very fortunate that the community rallied behind that. The state also got engaged to provide some funding to help get it off the ground. And here we are. We're really excited about it. 

Erin Spain, M.S. [00:01:56] It is very exciting. Allen, I want to talk about the name of this medical center, Black River Medical Center. It's a nod to the river that really courses through many of the communities this hospital will serve. Tell me about those communities and the people living there. 

Allen Abernathy [00:02:10] First, great communities, fantastic folks that live in these areas, so focused on their communities and supporting each other. I made nothing but great friends in both of these communities. The name Black River comes from finding a common ground between two communities, right? We wanted to make a facility that really was community focused. And I think Black River is really the common ground, a kind of nod to that, to that community, like you mentioned. So we're really happy and we're excited about the name, excited about this new facility. 

Erin Spain, M.S. [00:02:42] You've really been boots on the ground during the construction phase of this project, while also maintaining duties as the CEO of the Williamsburg Regional Hospital. The Black River Medical Center is unlike any other medical center in rural South Carolina right now. Tell me about that. What does it offer? 

Allen Abernathy [00:02:59] Right now, this is a 64,000 square foot facility and there are a lot of new services coming to the community. So we'll have 3D mammography, not available in either community currently. We've installed the first MRI machine ever in Williamsburg County, so there'll be 25 inpatient beds, five observation rooms, 16 ED beds. We'll have a full complement of virtual telehealth for services. But what this facility really means to this community is an access to care that was otherwise unavailable and access to huge, huge resources at the Medical University of South Carolina. 

Erin Spain, M.S. [00:03:37] Jay, could you share some other examples of how the facility meets efficiency and accessibility goals? 

Jay Hinesley [00:03:43] One of the beautiful things about building a new hospital is that you get to bring it up to today's standards and you get to design it in a way that is built around how we provide health care today. Most hospitals in America were built based on the Hill Burton Act, which was many, many years ago, and they were designed for health care 50 years ago. And a lot has happened in 50 years. And so we had the benefit of being able to design a building around how we plan to operate and how we operate today and potentially even into the future. So that means that we have very robust technology in the facility that allows us to connect patients to physicians and providers across the state of multiple specialties, whereas you would previously need to recruit a person to that community in order to provide that service. We can now dial them up in a high-quality image with a high quality sound in a way that is almost like they're there and provide the services without having to recruit a physician to that market. So that's just one area. Really fortunate to have MUSC Health's robust telemedicine network that we'll be deploying at Black River Medical Center, but also the design of the building allows for services to be provided and in a way that we can share responsibilities among departments. One good example is that the cafeteria is designed in a way to double as a meeting space, and that allows us to have a little bit smaller footprint. Means a little bit less building to maintain a little bit more efficient space. You know, it's a transition space that can be used in multiple different ways. The registration area is designed in a way that allows them to register patients across the facility, whereas we would normally register patients for outpatient, we register patients for inpatient, we may register patients for surgery, in the old model. And today registration in Black River Medical Center will be in one location. And that's a great way to create efficiencies in a facility, is people often wearing multiple hats but living in one area in the hospital to take care of patients throughout the facility. 

Erin Spain, M.S. [00:05:35] And you mentioned virtual telehealth and how this is such an important part of the plan of the medical center. Tell me a little bit more about MUSC Health's vision for telehealth and what's going to evolve in years to come. 

Jay Hinesley [00:05:48] Yeah, I think we could probably project a lot of things that will happen in the next 20 years, I would say. If we start from the beginning, telemedicine started as a program in the ER that allowed neurologists to identify and treat stroke patients. And that started within the last 10 years. And it's now evolved to include services like palliative care, infectious disease. We've got telehospitalist programs in the state that allow internal medicine doctors to provide assistance to patients in the hospital. If you look at the trajectory of health care, we are going to have a shortage of providers in the next 10 years. So telemedicine will allow us to connect physicians to communities like Black River Medical Center in a way that we've never had to do before. You could even project potential advancements in technology that could potentially allow surgery to be done remotely. Some of those are happening throughout the world even. People are experimenting with that. We're not doing that in Black River Medical Center, let's be clear. But if we're talking about advancements in technology and in telemedicine, I think we have to think about it in that way. And really, those communities are going to be on the cutting edge of that technology and those advancements over the next 10 years. 

Erin Spain, M.S. [00:07:01] I'd say this could be a model for other rural hospitals around the country. 

Jay Hinesley [00:07:06] I think we expect it to be. MUSC Health is an innovative health system and we certainly intend to be leading the pack when it comes to rural medicine. 

Erin Spain, M.S. [00:07:15] Speaking of the virtual world, a lot of this hospital was designed during the COVID-19 pandemic, and there was a lot of collaboration online. Can you tell me a little bit about that and what that experience was like to design a hospital when everyone's at home? 

Allen Abernathy [00:07:31] A hundred percent of this hospital was designed via teams, and normally it takes a village to plan these hospitals. A lot of folks take off of work to sit in rooms for days on end, going through design elements and what needs to be where. And I think the silver lining to this was we had functional leaders from Williamsburg and from Lake City and from Florence and from Charleston planning this hospital together. And I think there's so many cool features that came with this because we had that participation from all of those markets. We've offset all the gasses in the patient rooms so nurses don't have to reach over their patients to access those. We've got a special exit for our emergency room that goes to the front of the hospital just in case of emergencies dropped off at the front door and doesn't come via ambulance. You know, we've got a private discharge that's solely so we don't have to parade our patients through the lobby after a few days' stay at the hospital. A lot of really cool features came from having that collaboration. I did want to mention one other thing, too, that I think is really cool about MUSC and how they plan things. On almost every one of our calls, we had patient advocates, and those patient advocates made sure that us hospital folks were designing a hospital and actually thinking about patients. And so it gave us that patient perspective when we were working through how this hospital should look and function. 

Erin Spain, M.S. [00:08:59] And how excited are the staff, Allen, to be working in this hospital that's really been designed for them and their patients? 

Allen Abernathy [00:09:06] I mean, what they're most excited about is having dependable and sustainable health care in their communities. So these folks that take care of patients, they live in these communities. They've grown up in these communities. They're there because they want to take care of folks in their community. So they're ready for new technology and a new building. And like I said, sustainable health care. 

Erin Spain, M.S. [00:09:29] So walk me through who might be coming through the doors of this new hospital and when might they end up going to Charleston or a different hospital? When does that make sense? 

Jay Hinesley [00:09:39] When you look at how health care has changed over the last really even 10 years, you know, we do a good job of providing medical care for chronic conditions in rural hospitals. And so we've done a great job of connecting physicians that manage chronic conditions like diabetes and COPD and lots of things that put people in the hospital. The vast majority of conditions that people end up in the hospital for are medical. They're medical, meaning that we can treat them with medications. We can treat them with certain interventions that just require a physician to be engaged, helping us work through those processes. When you get to a point where you need a surgery, a complex surgery or just a heart surgery, for instance, you've got a complicated orthopedic surgery that needs to occur. You know, you're going to find yourself needing a little bit more robust facility. And oftentimes that's because you have to have a surgeon that's skilled enough to do the surgery. But also the aftercare can be challenging and difficult and takes specialized personnel to take care of you. So in Black River Medical Center, we're going to take care of the vast majority of medical conditions so that people can stay in their communities and be treated by their neighbors, if you will. But if it gets to a point where you need a more complex surgery, heart surgery is a perfect example, you're going to end up needing to relocate to a facility that does that, whether it be the MUSC Florence facility or MUSC Charleston, that will be able to handle the vast majority of conditions that come through either the ER or through the physician clinics in those communities. 

Allen Abernathy [00:11:06] Just because you need to come to another facility for a really complicated surgery doesn't mean that you can't have a lot of your pre and post surgical workup in your community. So not only are we taking care of folks acutely, but we provide a lot of diagnostics that a lot of folks travel outside of their communities for. And so they'll be able to have those, you know, under a fantastic name brand right there locally. 

Erin Spain, M.S. [00:11:36] In some ways, this may be just the beginning. The center is expected to grow after its opening in January 2023. Tell me, what's the long-term vision for serving this area? 

Jay Hinesley [00:11:47] Well, MUSC Health is all in. I think that's the most important point, is that we are all in regarding taking care of the communities that we serve. And so I think it's a commitment to Williamsburg, it's a commitment to Lake City that they will have high quality health care as long as MUSC Health is around. And I don't think MUSC Health is going anywhere. So we're excited about that. We certainly anticipate health care is going to continue to change. And as it changes, we anticipate being able to add services accordingly. 

Erin Spain, M.S. [00:12:17] When designing this hospital for this particular community, were there certain things that you thought of as far as occupations, more farming, for example, different occupations in that area? Was that something that you thought of when designing this hospital? Like who's going to be coming through these doors, maybe in an emergency situation? 

Allen Abernathy [00:12:35] Rural communities have a lot of emergencies, and we're often the place that is the touchdown for anything serious, complex and urgent emergency care. For that reason, our ED is very accessible. Our CT scanner is very close to the entrance ambulance entrance. As for our stroke program, we have good sized ED: 16 beds, 4 observation rooms. We can flex to 20 if we need to in that ED, and we're going to be focused on throughput and making sure we have those services available to take care of folks. So, yes, a lot of the emergent care — I mean, we'll have fantastic emergent care there. You know, as far as the rest of the facility, you know, we are geared towards access, we're geared towards chronic disease. I mean, we base some of our programs off of our community health needs assessment, like we'll have a lung cancer screening program, we'll have a calcium score screening program. So we'll have a lot of the programmatic stuff in that addresses lung disease, that addresses cancer, that addresses heart disease. I mean, we're bringing those programs and those services to the community. And so, you know, I guess to answer your question, absolutely, we're thinking of the rural community when we build this. 

Erin Spain, M.S. [00:13:49] What would you say to those listening about this facility? Why would you encourage them to come and just take a look once it's open. 

Allen Abernathy [00:13:55] This is their facility, right? So like Lake City and Williamsburg Regional Hospital, those guys are passing the torch to MUSC. So this is their community hospital. And through their support, they'll continue to have access to great services and will continue to grow, and will provide, will keep doing these community health needs assessments. We'll follow the trends. And I mean, our mission is to improve the health and well-being of this community. So I would say to those guys, it is their hospital. And I think, you know, a lot of folks when they come to see this hospital, they go, oh, my gosh, it's much nicer and much bigger than I thought it was. 

Erin Spain, M.S. [00:14:35] What do you do to optimize your health and live well? 

Allen Abernathy [00:14:38] So for me, I think what I do is I'm just trying to eat healthy. I try to take care of myself, you know, for any kind of exercise. I think I just spend the vast majority of my time after I get off work chasing after children. 

Jay Hinesley [00:14:52] I married the right woman. She helps keep me on track. And I agree with Allen. As my wife, she makes sure that I eat healthy, encourages me to walk often and keeps moving, which is really important, obviously. And sleep. I find that sleep is really important to your health. 

Erin Spain, M.S. [00:15:13] For more information on this podcast, check out Advance.MUSCHealth.org