March 19, 2020

Jeff Balser, MD, PhD, on altering approach to elective care

Here’s the latest information on our coronavirus response. The situation is changing by the hour and we will keep you informed as we determine what’s best for our patients — and for all of us at VUMC.


Hi, everyone.

Here’s the latest information on our coronavirus response. The situation is changing by the hour and we will keep you informed as we determine what’s best for our patients — and for all of us at VUMC.

Jeff Balser, MD, PhD

Like most hospitals in the country, we are beginning to see some of our own people develop coronavirus. To-date that number is less than 10. We believe none have become infected through patient contact and all are in quarantine at home. However, the number of confirmed cases in Middle Tennessee is rapidly growing. Nearly 1,000 people per day are now being evaluated in the testing centers we have deployed around the city. In order to assure we have the people, and the supplies, to manage the growing demand, we are altering our approach to what is known as “elective care.”

Elective means “scheduled,” as opposed to emergency. It does not mean the care isn’t important. In fact, much of our elective care cannot be delayed, and needs to be done “on schedule.” To keep you safe, we are expanding social distancing measures in our facilities. We’ve reconfigured waiting rooms to create more distance between patients, and when it’s possible to use cell phones, we’re encouraging patients to wait in their cars instead.

In addition, we are asking our clinical teams to move as many scheduled, on-site clinic visits as possible to telehealth visits, so that timely care can continue. The good news is that our health IT teams and access center staff have rapidly developed an excellent telehealth platform in My Health at Vanderbilt that our patients can easily use. More than half a million patients are already using My Health for other purposes, and the number of patients activating their accounts is growing rapidly. All of our clinicians are quickly learning to use the platform through eStar, with more than 1,000 already trained. We have the advantage that many of our specialties were already successfully using telehealth. This will all allow us to continue to provide timely care to many thousands of patients.

In some cases where scheduled clinic visits can simply be delayed, we are working to reschedule those for a later date. A challenge is patients who are scheduled to have procedures in the next few weeks. Importantly, decisions about whether to proceed are being made by our clinicians through communication with their patients. If delaying a procedure for more than 8 weeks will be detrimental to a patient’s health, those procedures will continue as planned. The number of procedures we delay will be adjusted daily, and depends on our staffing, equipment and the number of coronavirus patients coming to VUMC.

At our inpatient facilities, we are reallocating some patient beds as we get ready for the arrival of coronavirus patients. The new beds we just completed in Medical Center East — which can flex between regular and ICU care — are ideal for patients with respiratory illness and will help us keep the remainder of the inpatient beds in Vanderbilt University Adult Hospital some distance away from our coronavirus care.

Importantly, our research enterprise continues to function to perform critical, life-saving work, including intense efforts surrounding coronavirus. By staggering schedules and working from home when possible, we’re doing our part to create social distancing in our labs and clinical research areas.

I know the last couple of weeks have been trying — with long hours and stressful conditions. The next few weeks will continue to be challenging. We must all take care of each other. This city, this region is counting on us. Together, we are making a difference — and caring for people when they need us most. Thank you.


Jeff Balser, MD, PhD
President and CEO, VUMC
Dean, Vanderbilt University School of Medicine