[관련기사=LA할리우드 차병원이 매출 6000억원, LA 최대 종합병원된 사연은?]

[MedigateNews] CHA Hollywood Presbyterian Medical Center is a symbol of pride as South Korea's first medical institution to successfully export healthcare services. It stands as the inaugural example of South Korea showcasing its excellent healthcare infrastructure on a global scale.
 
Deficit hospital acquired, surpasses USD 444 M in revenue last year
 
CHA Hospital Group's acquisition of the Hollywood CHA Hospital in 2004 for $69 million became famous as a bold investment that turned around the hospital from a deficit to profit within three years. To understand how CHA Hospital operates within the U.S. healthcare system, I visited the Hollywood CHA Hospital in Los Angeles.
 
Upon arriving at the hospital, one striking observation was its size, much larger than anticipated. Situated in the heart of Hollywood, it boasted an expansive area of 100,000 square meters, with facilities so impeccable that it was hard to believe the hospital had been established a century ago. Construction for a new ward with state-of-the-art facilities was in full swing right next to the main building.
 
The Hollywood CHA Hospital accommodates a total of 500 beds and employs over 1,500 staff, including 500 medical professionals. Despite the challenges posed by the COVID-19 pandemic in 2021, the hospital recorded revenues of USD 379.28 M, establishing itself as the largest private comprehensive hospital in the LA area. Last year, its revenue surpassed USD 443.95 M. The hospital admits approximately 20,000 inpatients, treats 35,000 emergency cases, and facilitates 5,000 childbirths annually.
 
Offering a wide range of medical services from obstetrics and pediatrics to stroke centers, the hospital's standout feature is its emergency medical care. The hospital prioritized enhancing the emergency medical system and introduced the 'Express Emergency Center' system in 2018. This system classifies walk-in patients based on the severity of their conditions and provides medical services promptly in a staged manner.
 
This overhaul drastically reduced waiting times. Typically, emergency centers in the U.S. require patients to wait for 4 to 6 hours to receive treatment. Before the restructuring, Hollywood CHA Hospital also had an average waiting time of around 4 hours, leading to dissatisfaction among patients, as indicated in patient satisfaction surveys.
 
To implement the Express Emergency Center system, the hospital formed a task force consisting of more than 20 medical professionals, including doctors, to design the most efficient system from both medical and administrative perspectives.
 
The core of the Express Emergency Center system lies in classifying patients into three categories and providing immediate medical services. Upon arrival at the emergency center, patients undergo immediate initial assessments, followed by categorization based on their conditions (mild, moderate, severe) to ensure swift treatment for those requiring medical attention.
 
To expedite the emergency care process, Hollywood CHA Hospital transitioned from verbal inquiries to written documentation for pre-registration. Additionally, the hospital provides services in multiple languages to accommodate a diverse patient population and offers medical service photo guides to aid patient understanding.
 
As a result of these improvements, the waiting time from emergency room admission to discharge was reduced from 4 hours to 1 hour and 30 minutes. Even in cases requiring additional inpatient treatment, the waiting time was reduced to approximately 2 hours.
 
Efforts to reduce readmission rates and provide continuous medical services
 
The hospital is currently investing USD 400 million in constructing a new building. Spanning 10,068 square meters from the ground floor to the fifth floor, the emergency room is equipped with a negative pressure system, ensuring patients can receive treatment without infection concerns. Compared to the previous emergency room, the new facility expands by approximately 30% and includes emergency rooms, wards, delivery rooms, neonatal intensive care units (NICU), cardiac catheterization laboratories, and operating rooms.
 
The new facility adds 5 negative pressure rooms and rooms equipped with blood oxygen monitoring systems. Moreover, anticipating a surge in patients that could strain connections with regular wards, 33 single rooms are designed to be easily converted into shared rooms when needed.
 
Hollywood CHA Hospital is also making efforts to reduce patient readmission rates. The hospital has introduced a 'Continuing Care Program' offering tailored intensive treatment programs, including home care and remote consultations, for 90 days after patient discharge.
 
Through these initiatives, the hospital addressed issues in the traditional U.S. Medicare payment system, where despite high medical costs, continuous medical services were not provided. They improved quality and efficiency by implementing bundled payments, thus enhancing the quality of care.
 
Robert Allen, CEO of Hollywood CHA Hospital, stated, 'The new facility has significantly enhanced our emergency room. Not only has it increased in size, but we have also installed state-of-the-art radiological machines and systems right next to the emergency room,' calling it an 'extraordinary occurrence' for a community-sized hospital.
 
One of the hospital's strengths is the ability to provide personalized treatment. Kim Bora, Chief Project Officer (Psychiatry Specialist) at Hollywood CHA Hospital, explained, 'The United States has more medical staff assigned per patient compared to Korea. There are mandatory ratios, such as 2:1 for ICU and 4:1 for emergency rooms in terms of doctors to patients.' She added, 'While Korea's medical infrastructure is top-notch globally, without an environment where professionals can properly care for patients, providing personalized treatment becomes challenging.
 
Overseas expansion challenges, overcome through localization and active Investment
 
However, it is challenges for domestic hospitals to expand overseas. To successfully operate medical facilities abroad, collaboration with domestic medical institutions is essential, but there are often legal complexities.
 
Kim Bora, Chief Project Officer, commented, 'There are many regulations regarding overseas expansion in domestic medical laws, making it difficult to establish proper synergy with domestic medical institutions.' She added, 'The stringent and intricate insurance systems and cultural differences in the U.S. medical industry can pose challenges, and local adaptation and community engagement are also demanding.'
 
She emphasized, 'While trust in the Korean medical standard is generally high overseas, one must be mindful of potential issues arising from minor cultural differences.'
 
To preemptively address these issues, Hollywood CHA Hospital focuses on understanding and empathizing with local cultural nuances. They work towards formalizing this understanding as a part of their processes. Additionally, the hospital actively builds strong relationships with the local community and contributes to local development through volunteer efforts.
 
Kim Bora, CPO, explained, 'To overcome challenges during the hospital's initial acquisition in LA, we recruited experienced management professionals and invested significantly in medical equipment to provide customer-centric advanced services.' She continued, 'To enhance customer satisfaction, we introduced a Concierge service and operated a special Korean ward on one floor. We imported directly from Korea, offering services such as 10-year aged soy sauce brewed in-house and traditional Korean dishes, including seaweed soup, along with 24/7 access to Korean TV. These specialized Korean services helped attract patients and generate profits.'"
 
by Kyungdae Ha