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The Future of Healthcare: Major Upgrades Ongoing at Watauga Medical Center

The Future of Healthcare: Major Upgrades Ongoing at Watauga Medical Center

Schaefer Family Patient Care Tower

The Future of Healthcare: Major Upgrades Ongoing at Watauga Medical Center

 

Originally published in High Country Magazine, Aug/Sept 2021. Used with permission.

Healthcare in the High Country has come a long way since 1925, when Dr. Henry B. Perry moved into Boone’s first hospital facility in the Lovill House Annex. Blanford B. Dougherty established the infirmary – where Dan’l Boone Inn is currently located – to support Watauga Academy, now Appalachian State University, and the surrounding town.

After operating on the university campus for 29 years, a new Watauga County Hospital, now Watauga Medical Center, was built at its current location on Deerfield Road. Its first patients entered the building on March 23, 1967.

The original building was constructed through money allocated by the Hill-Burton Act of 1946. This piece of federal legislation, signed into law by President Harry S. Truman, allocated money to states for the purpose of constructing hospitals and healthcare facilities.

Since that time, Watauga Medical Center (WMC) has served the healthcare needs of countless patients, including a major expansion in 1980 and continual additions of new and updated services.

The quality of care continued to improve after the 1980 expansion, but infrastructure problems such as power failures and repeated HVAC system repairs have plagued recent years. These issues prompted stakeholders to begin planning for infrastructure upgrades.

Rising to meet the community’s needs

 

Appalachian Regional Healthcare System (ARHS) has begun a $126 million construction project, making structural and technological enhancements to ensure the delivery of premier healthcare into the future.

“When we started talking about this project initially, it involved building a new bed tower and moving outpatient services back to campus in a new medical office building,” said Rob Hudspeth, Sr. Vice President for System Advancement at Appalachian Regional Healthcare System and the President of the Appalachian Regional Healthcare Foundation. “The board of trustees started considering how to make that happen – if we could afford it and how it would impact services until we were able to build it all. Meanwhile, our new CEO Chuck Mantooth was transitioning into the role Richard Sparks had filled for more than 30 years.”

To aid in the initial plans for hospital expansion, a team of Master of Architecture students from Clemson University’s Architecture + Health Concentration visited Boone to perform a needs assessment and survey the land. They performed the initial assessment and made recommendations for the bed tower and medical office building. Soon however, power plant issues began to arise, changing the initial building plans for the hospital.

“We had a prolonged air conditioning failure during the hottest week of 2019 because of old and outdated HVAC equipment. While we were thankful for the support we received to try to keep our facility as cool as possible, our board of trustees realized we needed to consider major upgrades. They approved an engineering survey to review all our systems. Charlotte Engineering’s report stated we had multiple issues that needed to be addressed. The cost was estimated at $22 million to repair the 60-year-old building,” Hudspeth said. “Our central energy plant was antiquated. If you don’t have power, it’s hard to do surgery; it’s hard to keep patients comfortable and provide quality healthcare for them.”

The decision to replace the central energy plant at WMC added approximately $28 million to the project cost which is being funded from a $126 million bond issuance.

“We felt like it was the right thing to do for the community. We were designated by the Centers for Medicare and Medicaid as a five-star hospital, but we know we can’t keep delivering five-star care in a 60-year-old building,” Hudspeth said.

“The expansion project started with the new central energy plant,” Hudspeth said, “because we couldn’t just tear down the power plant and build another one in its place. It has to be a staged, staggered approach. The new central energy plant will give us all of the modern technology and power we need.”

The new 100,000-square-foot energy plant will include two fire tube dual fuel steam boilers, three condensing boilers, five hot water heating pumps, three 750-ton water-cooled centrifugal chillers, a three-cell cooling tower, two 30,000-gallon above-ground fuel tanks, two 2,500 kilovolt-ampere (kVa) utility transformers and a 1,000-kilowatt (kW) generator.

“For years, ARHS has successfully worked around limitations in space and declining buildings that have kept us from achieving our full potential. It’s time we invest in people, systems, and facilities. This will expand our opportunities and position us for the future,” said Chuck Mantooth, President and CEO of Appalachian Regional Healthcare System. 

A new and improved patient care tower

 

A new 48-bed tower will provide larger patient rooms capable of accommodating high-tech mobile medical equipment, state-of-the-art surgical suites, an updated Emergency Department, new waiting areas, and more. A new two-story entryway will greet patients as they enter the building, with natural light and serene mountain images.[/caption]

Watauga Medical Center is currently licensed with 117 beds, which is enough for inpatient demand, so the bed tower will not add additional beds. This new facility will allow the hospital to create new modern spaces and renovate and repurpose space in the current facility.

Patient privacy is a primary concern of the new building. Separate patient and visitor elevators are planned for the bed tower to provide more privacy for patients traveling to and from their rooms for diagnostic tests, surgery or physical therapy. Built-in medication carts will be integrated into the six new surgery suites so all necessary supplies are at the staff’s fingertips.

The bed tower will also be home to women’s health services as well as imaging and laboratory services – both of which are currently located outside of the hospital. Patients will be greeted by new registration and waiting room areas.

Along with the expansion to the new patient care tower, the existing space will be upgraded and utilized. For example, a brand-new Intensive Care Unit recently opened inside the current hospital building.

A new era of surgical excellence

 

Image: New Surgical Suite at Watauga Medical Center

New operating rooms will have plenty of space for the advanced technology needed for every surgical specialty.

Along with the new building comes a whole new era of new technology advancement at Watauga Medical Center. A major feature of the new patient care tower is a spacious, efficient and modern surgical suite.

“The current 300-square-foot surgical rooms limit our capabilities for advanced procedures like robotics-assisted surgery and orthopedic joint replacements, “said Kevin Henson, Senior Director of Surgery and Anesthesia Services for ARHS. “Many of the rooms are just not big enough for the equipment needed.”

In designing the new surgical space, a cross-functional planning team considered facilities such as WakeMed, UNC Health, Duke Health and others, and aimed to meet or surpass the technology available in larger metropolitan areas of the state. Watauga Medical Center, already a high-achiever in quality metrics, will be considered one of the premier hospitals in North Carolina.

According to Henson, the expansion will double the space of every new operating room. “With the expansion and design of these rooms, we can extend our robotics program. Every room will be able to handle the various needs of all surgical specialties, rather than relegating certain procedures to only certain operating rooms.” The new surgery department design will also have the pre-op and post-op rooms close to the operating rooms to improve efficiency.

Image: New Patient Room

New patient rooms will also have space for updated technology, as well as reimagined atmosphere and visitor space.

“On a typical surgery day, surgeons can log more than 18,000 steps and spend precious time they could use for patient care. They walk from one area of the hospital to speak with the family before surgery, then travel a couple long hallways to scrub in, and back down another hallway to go into the surgery department,” Hudspeth said. “We will relocate departments that work closely together to allow for more efficiency and a seamless transition between services.”

Watauga Medical Center has recently seen people traveling longer distances to receive care at the hospital. A significant portion of outpatient and inpatient surgery patients live outside Watauga County. “It’s a testimony to the vision that is being realized,” said Henson, “and it’s going to be an incredible facility for this small community.”

ARHS leaders hope the expansion will help them continue to recruit talented physicians, nurses, and staff. In addition to patients seeking out Watauga Medical Center for their procedures, they anticipate that doctors and healthcare professionals will increasingly view ARHS as an employer of choice and a place they want to be for a long time. Currently, many of Watauga Medical Center’s healthcare professionals live in Wilkes County, Ashe County, Caldwell County, and even across the state line into Tennessee. Many top physicians are also relocating to the High Country from other states, drawn by the facility improvements, the beautiful local area, and more.

A new and improved Heart and Vascular Center

 

One of the earliest efforts of this expansion was a new Heart and Vascular Center. Formerly known as The Cardiology Center, the 8,000-square-foot facility opened in a new heart care wing at the medical center on August 17, 2020.

The Heart & Vascular Center provides more efficient and convenient access for patients, by integrating outpatient heart care with diagnostic services in the same convenient location. The center includes twelve exam rooms, three device rooms, and two heart failure treatment rooms. The new name represents the enhanced service offerings and multi-disciplined team of board-certified cardiologists, advanced practice providers, cardiac nurses, office staff, and device technicians that all partner with patients to manage symptoms, monitor medications, and create customized treatment plans.

“Bringing services – diagnostic testing, catheterization lab, etc. – under one roof reduced the wait time for patients and enhanced the level of interaction between medical professionals to collaborate and delivered customized care,” said Kim Bianca, President of Watauga Medical Center.

After analyzing the number of people WMC was sending ‘off the mountain’ for cardiac catheterizations – approximately 300 each year – ARHS invested millions hiring additional cardiologists and enhancing the cardiac program.

“During a cardiac emergency, time is muscle,” Bianca said. “Any delay in restoring blood flow increases the chance for significant damage to the heart muscle.”

The WMC catheterization lab is open 24 hours a day, 7 days a week, 365 days a year. High Country residents no longer have to leave the mountains for interventional and diagnostic services from the nation’s top medical professionals.

The future of Family Medicine, Wellness and Orthopedics Programs in the High Country

Over the last several years it has become evident that access to primary care, including family medicine, is a challenge in the High Country.

MAHEC Family Medicine Residents

First- and second-year residents with MAHEC Rural Family Medicine Residency Program

The MAHEC Boone Rural Family Medicine Residency Program, located at Watauga Medical Center and AppFamily Medicine is a partnership between ARHS and Mountain Area Health Education Center (MAHEC) and will also serve as a clinical training site for medical students from the University of North Carolina School of Medicine. The program was created to train full-scope family doctors to serve in rural and underserved communities. Resident training will take three years, and ARHS and MAHEC are hopeful that many residents will choose to continue their careers in the High Country.

The Watauga Medical Center expansion ensures that resident doctors will be able to train in the most up-to-date, advanced environment while providing care to our rural population. A $1 million investment will be made into the future of the residency as a part of the capital fundraising campaign that supports the overall project.

“We are enormously excited to welcome these family medicine residents,” said Molly Benedum, M.D., Director of the MAHEC Boone Rural Family Medicine Residency Program. “Their interest in our program indicates their strong commitment to spending their careers meeting the primary healthcare needs of communities across the state. We look forward to what they will accomplish in the years to come.”

Recognizing the relationship between physical fitness training and healthcare for joints and bones, ARHS is allocating $1.5 million to relocate their acclaimed orthopedics programs to the Paul H. Broyhill Wellness Center. Orthopedic physicians will now be able to collaborate more closely with physical therapy and wellness staff to provide access to specialized pre-surgical training and post-surgical physical therapy.

Jackson working out post-surgery while trainer Tiffany coaches

Jackson working out post-surgery while trainer Tiffany coaches

David Jackson, President and CEO of the Boone Area Chamber of Commerce, greatly benefitted from a customized pre-surgery conditioning program before orthopedic surgeon Dr. Steven Anderson performed his hip replacement procedure. This “prehab” gave him the best possible chance of overcoming his lifelong struggle with a rare condition and chronic hip pain that threatened to destroy his active lifestyle and consume his family life.

With the growing number of active seniors in the High Country, people who use the Wellness Center for fitness may increasingly find themselves in the midst of a major health event where they experience illness or need surgery. They may need help to get back to their previous level of activity.

Fitness services, cardiac and pulmonary rehabilitation, physical and occupational therapy through The Rehabilitation Center, and other clinical wellness programs are currently housed in the 54,000-square-foot building. With the addition of AppOrtho orthopedics and sports medicine, ARHS can consolidate services and help patients successfully navigate the cycle of wellness and rehabilitation.

“We wanted to take the integrated care concept and create a unique space – something special for the community,” said ARHS President and CEO Chuck Mantooth. “With our specialized staff, trained to work with different health populations, we can help people live up to their potential at any age and condition.”

Support from Appalachian Regional Healthcare Foundation

Appalachian Regional Healthcare System is a 501c3 non-profit organization that reinvests earnings to improve healthcare services for the High Country. It is important to note that construction of the central energy plant and bed tower will not raise taxes for residents or require the use of town or county funding.

In addition to the $126 million bond issuance for construction, the ARHS foundation has been tasked with raising $12 million through a capital campaign for ancillary costs such as people, programs, and technology to enhance the project further.

“Our foundation hired a consulting firm from Winston-Salem to perform a feasibility study and help develop our fundraising plan. We surveyed people in the community about a variety of themes around healthcare delivery,” Hudspeth said. “We are currently in the silent phase of the $12 million capital campaign and have raised about $6 million.”

Created in 2007, Appalachian Regional Healthcare Foundation engages with the community to identify individuals, businesses and organizations who want to partner with ARHS in providing for the healthcare needs of the community.

Appalachian Regional Healthcare System has been able to continue to provide excellent healthcare in part because of the generosity of full-time and seasonal residents in the High Country.

“The support the foundation has been able to garner from seasonal residents is vital to our success, and we couldn’t provide this funding without them,” Hudspeth said.

To kick off the capital campaign, the foundation received two major gifts from generous benefactors to recognize the excellent care they have received in the past.

Tom Dale, Rob Hudspeth, Peter Rucker, Bonnie Schaefer, Jamie Schaefer, Chuck Mantooth

Tom Dale, Rob Hudspeth, Peter Rucker, Bonnie Schaefer, Jamie Schaefer, Chuck Mantooth

The first gift came from Blowing Rock residents Bonnie and Jamie Schaefer, together with their family, Marla Schaefer and Steve Weishoff, who generously gave $3 million for the future Schaefer Family Patient Care Tower at Watauga Medical Center.

“They say people make a place and it’s a good thing, because the core hospital, built in 1967, is dated, in disrepair and in need of improvement,” said Bonnie Schaefer.

“Watauga Medical Center offers life-saving medical care to those living in the High Country,” said Jamie Schaefer. “The patients and healthcare professionals need and deserve a new, state-of-the-art hospital.”

On June 17, 2021, Blowing Rock resident Ken Lewis surprised his wife, Donna, with a $1.5 million contribution to ARHS in her honor to name the new Donna C. Lewis Heart and Vascular Center.

Both Donna and Ken have needed cardiac interventions in the past. “Donna had some heart issues and she needed repair work about 15 or 16 years ago. I’ve had a heart stent myself,” Lewis said, “When this (capital campaign) came up, I thought about how lucky and blessed we were to have the ability to access this kind of facility.”

Lewis noted that as seasonal residents, they typically have all the facilities and technologies nearby their primary homes to address emergency situations. “But that is not necessarily the case when you are in the mountains,” he said, “It’s all about time in those situations. We have what we think are the best hospitals in the world [in our primary home cities], but they might as well be in China. At certain times of our lives, it is all about this hospital [in Boone]. It may be enlightened self-interest, but it’s also about all of the things we can do for the people of this region and this community. This is a great thing to do because it will help save people’s lives and Donna and I feel privileged to be a part of it.”

The Appalachian Regional Healthcare Foundation hopes to have continued success to fully fund the capital campaign. For more information, and opportunities to contribute, visit apprhs.org/higherelevation.

New pregnancy care and childbirth options at AppFamily Medicine

New pregnancy care and childbirth options at AppFamily Medicine

 

September 30, 2021

In the High Country, access to medical specialists has been on the rise. Appalachian Regional Healthcare System (ARHS) has recently added or enhanced services such as cardiology, orthopedics, obstetrics and gynecology, and much more. It’s a promising development. But as a result, the true role of the family medicine (or primary care) provider may not be fully understood in today’s highly-specialized and compartmentalized view of healthcare.

AppFamily Medicine aims to educate the community about their approach to treating the whole person and the whole family throughout every stage of life. And they are taking steps to create a true family practice from birth through childhood and throughout adult life.

They established the practice and added full-service pediatric care and a same-day/walk-in clinic. The next phase of their approach is to create a prenatal clinic and deliver babies at Watauga Medical Center.

 

A big step for women’s healthcare

Dr. Beverly Womack In 2008, Harmony Center for Women opened its doors to create a central location for women’s health, including gynecology, obstetrics and midwifery – to give women several options for how they wanted to receive care, and to cover all levels of care from routine to high-risk. Dr. Beverly Womack joined Harmony shortly after it opened and has provided women’s healthcare, prenatal care, childbirth and well as gynecological surgery throughout her career of more than 20 years.

Shortly after Harmony was established, Watauga County’s population grew significantly, and today 25% more people live in the county than they did in 2008. Appalachian Regional Healthcare System believes access to healthcare, particularly for women, must keep up with the High Country’s growth.

“We have a lot of patients in our region who have never had appropriate access to care,” said Dr. Womack, “and it is my passion to improve that.”

 

Meeting the growing community’s need

Enter the Mountain Area Health Education Center (MAHEC) Boone Rural Family Medicine Residency Program (residency program), which began at AppFamily Medicine and Watauga Medical Center in 2020. Family medicine residents are accredited doctors who have recently graduated from medical school. They receive three years of further training in six major medical areas — pediatrics, obstetrics and gynecology (OB/GYN), internal medicine, psychiatry and neurology, surgery, and community medicine. Those young physicians will be the future of family medicine in the High Country and other rural areas.

MAHEC Family Medicine Residents

First- and second-year residents with MAHEC Rural Family Medicine Residency Program

To accomplish OB/GYN training for these young doctors, AppFamily Medicine welcomes Dr. Womack as supervisor for obstetric and gynecologic education for the residency program.

She is teaching and supervising the family medicine resident physicians caring for women and children in the High Country. While she will no longer deliver babies with her own patients, she will assist the resident doctors in obstetrics and childbirth.

Dr. Womack treasures the “privilege to be with women in their most vulnerable and intimate and important parts of their lives.” Now, she can share that same passion and privilege with doctors in the first phase of their careers.

She sees patients 60% of the time for gynecology appointments, including well-woman care, emerging or chronic problems, and surgery. With the remaining 40% of her time, she will establish a prenatal clinic with the resident doctors.

“I have had such a good experience with the residents,” said Dr. Womack. “My time with them has really rejuvenated my enthusiasm for what I do. It made me reflect back on everything I’ve done so far. And it really made me start thinking about things I wish I had known when I was a younger doctor.”

In the AppFamily Medicine prenatal clinic, residents under the guidance of Dr. Womack will be seeing women with low-risk pregnancies and managing labor and delivery at Watauga Medical Center.

Dr. Womack believes having the residents assist her with patient care is going to “make it better for all of us.”

 

Full-circle healthcare for families

One key advantage of family medicine is that mothers can choose the same physician who delivered their baby for ongoing pediatric care. Dr. Charlie Baker, who practiced in Avery County for more than 40 years is a prime example of a full-circle family physician. He cared for pregnant women, delivered babies, cared for them throughout their childhood into adulthood – sometimes going full circle to deliver babies for women whom he had helped enter the world.

Looking into the future, Dr. Womack hopes to expand the times and locations where they can see patients, to lower the burden on women and the barriers to receiving care.

 

How to get care

1. If you are pregnant or plan to become pregnant and do not have a provider, call AppFamily Medicine at (828) 386-2222 or request an appointment online. Let the scheduler know that you are interested in gynecology and/or prenatal care.

2. AppFamily has general healthcare, gynecology and family planning services available for every stage of womanhood, whether you plan to start a family or not. Call today or request an appointment online to get established with a provider who can help you navigate all your healthcare decisions.

AppHealthCare and ARHS Urge Prevention as COVID-19 Cases Increase

AppHealthCare and ARHS Urge Prevention as COVID-19 Cases Increase

ARHS and AppHealthcare Logos September 1, 2021 – With COVID-19 cases and trends continuing to increase, AppHealthCare and Appalachian Regional Healthcare System are urging the community to take actions to prevent further spread and protect critical healthcare resources.

“We are concerned about the increasing trends we are continuing to see and want to urge everyone to help us control this virus to a manageable level. This pandemic has shown us that we are all connected. We all need each other. When we are in this type of response mode, we need everyone to take actions to help us get to a better place. We urge anyone who is unvaccinated to not wait and get a vaccine today. The vaccines are working like they should and helping prevent severe illness, hospitalization and death. We care deeply about our community and don’t want to see anyone experience hardship or loss due to this virus,” stated Jennifer Greene, Health Director, AppHealthCare.

Hospitalizations due to COVID-19, both locally and statewide, are increasing. As a result, capacity can become limited for all types of care like surgeries, treatment, procedures and emergency care. When all hospitals are experiencing a strain on resources, someone needing critical or emergency care may have to wait until a bed is available or until a transfer to another hospital is possible. Many regional hospitals are not able to receive transfers right now because of the number of COVID-19 patients they are treating.

DO NOT go to the hospital Emergency Department only for COVID-19 testing without a medical emergency. Using the Emergency Department for COVID-19 testing without a medical emergency takes limited resources away from community members who have medical emergencies and risks unnecessary exposure.

“Of the 20 COVID patients being treated at Watauga Medical Center today, 18 are unvaccinated. We have six patients on ventilators – 100% of those are unvaccinated,” said Rob Hudspeth, Senior VP of System Advancement for ARHS. “In light of these concerning trends, we hope people will strongly consider being vaccinated as our best hope for avoiding hospitalization and death from this virus.”

 

How Can I Prevent COVID-19?

Get a COVID-19 vaccine

  • AppHealthCare offers COVID-19 vaccines by walk-in or appointment Monday through Friday. Walk-in hours for vaccines are 1:00-4:00pm. If you choose to walk-in for a vaccine, you may have to wait. In order to lessen your wait time, please schedule an appointment. To schedule an appointment, call (828) 795-1970. More information: www.apphealthcare.com/covid-19-vaccinations.
  • Appalachian Regional Healthcare System offers vaccines at the following locations. More information: apprhs.org/vaccine.
    • AppFamily Medicine in Boone (828-386-2222). Appointment preferred Wednesdays, 3:30pm-6:00pm and Saturdays, 8:30am-11:00am
    • Baker Center for Primary Care in Linville (828-737-7711). Appointment preferred Thursdays, 10:00am-4:00pm and Saturdays, 8:30am-11:00am

Get tested

  • AppHealthCare offers drive-thru testing Monday through Friday 8:30-10:00am at each clinic location. No appointment needed and testing is free. Learn more at AppHealthCare’s website.
  • ARHS offers testing by provider referral. Do not go to the Emergency Department just for COVID-19 testing. For more information, visit apprhs.org/covid19-screening.
  • Additional testing locations can be found by using the NC DHHS Find My Testing Place tool.

Wear a mask in public indoor spaces regardless of your vaccination status

  • Wash your hands often with soap and water or use hand sanitizer
  • Keep a distance of at least 6 feet from others

With community transmission high, we urge everyone to know what to do if you are exposed or test positive for COVID-19. If you have specific questions, please reach out to the AppHealthCare COVID-19 message line at (828) 795-1970 and leave a message for a member of the COVID-19 response team to call you back.

 

I think I have been exposed to COVID-19, what do I do?

  • Quarantine yourself away from others for 14 days from last contact with a person who has COVID-19. During this time, monitor yourself for COVID-19 symptoms and get tested.
  • People who are fully vaccinated do NOT need to quarantine after contact with someone who had COVID-19 unless they have symptoms. However, fully vaccinated people should get tested 3-5 days after their exposure, even if they don’t have symptoms, and wear a mask indoors in public for 14 days following exposure or until their test result is negative.

 

What do I do while I wait for test results?

  • Stay home if you have any COVID-19 symptoms, were tested because you were exposed to someone with COVID-19, or you suspect you may have been exposed to COVID-19.
  • If you are sick or a member of your household tests positive, you should plan to keep your household members home, including children who attend child care or school, while you wait for results.

 

I tested positive for COVID-19, what do I do?

  1. If you test positive for COVID-19 and have symptoms, stay home as much as possible. Avoid others in your household until you can say yes to ALL three of the following questions:
    • Has it been at least 10 days since you first had symptoms?
    • Has it been at least 24 hours since you have had a fever without using fever-reducing medicine?
    • Has it been at least 24 hours since your other symptoms have improved (such as coughing and shortness of breath)?
  2. If you test positive and don’t have symptoms, stay home and isolate (avoid anyone in your household) until 10 days have passed since the date of your first positive COVID-19 test.

 

When should I seek emergency care?

  • Look for emergency warning signs for COVID-19. If someone is showing any of these signs, seek emergency care immediately. These signs include (but are not limited to). Learn more: www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html
    1. Trouble breathing
    2. Persistent pain or pressure in the chest
    3. New confusion
    4. Inability to wake or stay awake
    5. Pale, gray, or blue-colored skin, lips, or nail beds, depending on skin tone

 

Additional Resources

  • Appalachian Regional Healthcare System – For the most up-to-date information about COVID precautions, visitor restrictions, obtaining medical records and more, visit apprhs.org/covid19.
  • AppHealthCare – For local data, COVID-19 testing and vaccine information, visit www.AppHealthCare.com. For questions, call the AppHealthCare COVID-19 Message Line at (828) 795-1970 or email preparedness@apphealth.com.
  • North Carolina resources can be found on the NC Department of Health & Human Services (NC DHHS) website at covid19.ncdhhs.gov.
  • Centers for Disease Control & Prevention (CDC) website at cdc.gov/coronavirus.
Monoclonal Antibody Therapy (mAb) for certain high-risk COVID-19 patients

Monoclonal Antibody Therapy (mAb) for certain high-risk COVID-19 patients

Monoclonal Antibody Suite

August 31, 2021

The U.S. Food and Drug Administration (FDA) has issued an Emergency Use Authorization (EUA) to permit the emergency use of Monoclonal Antibody Therapy to treat mild to moderate COVID-19 in certain patients who test positive for COVID-19 and who are at high risk for progression to severe COVID-19, including hospitalization or death. It’s important to note that this treatment is not a substitute for vaccination against COVID-19.

Before you are exposed to COVID-19, The best way to reduce the chances of severe illness, hospitalization, or death, including from the Delta variant, is to be vaccinated. Learn more about how to receive a vaccine in Watauga and Avery Counties.

High-risk patients who have recently tested positive for COVID-19 and have had symptoms for 10 days or less, should talk to their healthcare provider to see if monoclonal antibody treatment is right for them.

This treatment is currently available at Appalachian Regional Healthcare System (ARHS) by referral only. 

 

What is Monoclonal Antibody Therapy (mAb)?

Your body naturally makes antibodies to fight infection. However, your body may not have antibodies designed to recognize a new virus like SARS-CoV-2, the virus that causes COVID-19.

Monoclonal antibodies, or mAbs, are lab-produced molecules that help your body fight off illness. Monoclonal antibodies can restore, boost or imitate your immune system’s response to the virus by replacing your natural antibodies. This treatment is administered by infusion. (source)

 

Who can receive mAb therapy?

High-risk adults ages 18 and older may be eligible for treatment through ARHS. The FDA has approved treatment for high-risk youth patients between the ages of 12-17 and weighing less than 88 pounds, however, ARHS does not currently administer pediatric mAb therapy.

High-risk factors can include:

  • Older age
  • Obesity or being overweight
  • Pregnancy
  • Chronic kidney disease
  • Diabetes
  • A weakened immune system or taking medicine that weakens your immune system
  • Heart disease including high blood pressure
  • Lung disease such as COPD, asthma, or cystic fibrosis
  • Sickle cell disease
  • Cerebral palsy or other developmental conditions
  • Regular use of a feeding tube or ventilator

Other medical or non-medical factors may also put individuals at higher risk for severe COVID-19.

 

Who cannot receive mAb therapy?

Monoclonal antibodies are not authorized for use in patients who:

  • Are hospitalized due to COVID-19
  • Require oxygen therapy due to COVID-19
  • Require an increase in baseline oxygen flow rate due to COVID-19 in those on chronic oxygen therapy due to an underlying non-COVID-19 related condition

 

How to receive mAb therapy through ARHS:

With 10 days of the first COVID-19 symptoms:

 

  1. Get tested for COVID-19
  2. If your test is positive, contact your primary care provider to ask if Monoclonal Antibody Therapy is right for you.
  3. If appropriate, your provider will send a referral to ARHS to schedule your mAb infusion appointment.
Healthcare System Responding to new COVID-19 Surge

Healthcare System Responding to new COVID-19 Surge

August 18, 2021

Appalachian Regional Healthcare System (ARHS) officials are extremely concerned about the latest surge of COVID-19 cases and encourage everyone to get vaccinated to protect themselves and those they love.

“COVID-19 rates are going up, again, in the High Country and hospitalization rates have followed,” said Chuck Mantooth, President and CEO of Appalachian Regional Healthcare System. “Our staff are working 24/7 to plan and manage this latest surge but we are experiencing a shortage of staff.”

What ARHS has done

  • Per federal regulations, ARHS continues to require masks be worn by all staff and visitors regardless of vaccination status.
  • Watauga Medical Center (WMC) has established three COVID-19 isolation units with the capacity to care for up to twenty-five critically ill COVID patients. WMC does have the ability to increase the number of beds to care for COVID and non-COVID related conditions.
  • Leaders meet daily to discuss how and where to expand capacity next if the surge moves beyond our current capacity.
  • ARHS contractors are working tirelessly to complete the renovation of the new ICU space early in order to provide an additional 10 ICU beds.
  • ARHS reinstated vendor restrictions on Monday, August 16th.
  • ARHS has established a pediatric work group that consists of hospitalists, pediatricians, and staff from the birthing center, respiratory therapy and critical care management to prepare for a potential surge in pediatric populations.
  • ARHS continues to enforce visitor restrictions at Watauga Medical Center and Cannon Memorial Hospital. Persons under the age of 18 are not allowed to visit or accompany a visitor. Visitors are required to wear a mask, at all times, while in an ARHS facility.
  • ARHS leaders have begun participating in daily WebEx meetings with regional partners and hospitals to discuss capacity and transfer options. Most large healthcare systems are at capacity and are currently “closed to transfers.”
  • ARHS has established a COVID Virtual Hospital to assist in helping less acute COVID patients recover while quarantined at home. These patients receive oxygen, a pulse oximeter, daily calls from nurse navigators to check vital signs – and are provided an emergency number if their symptoms worsen. We are currently working with the County to augment those services.
  • ARHS has developed a vaccination program for employees to ensure patient and co-worker safety. Until all staff are fully vaccinated, we have enhanced mask requirements to reduce the risk.
  • ARHS continues to allow isolated COVID patients to communicate with their family via FaceTime calls.

What We Have Seen

  • On July 13th, WMC did not have any patients hospitalized with COVID. As of today, there are twenty-one COVID patients at WMC. We have tripled our COVID patients in the last two weeks.
  • Non-vaccinated patients who are hospitalized during this COVID-19 surge exhibit greater symptom severity.
  • In this surge, approximately 80% of hospitalized COVID-19 patients are unvaccinated. These patients are requiring higher levels of respiratory support.
  • Patients who have received the vaccine generally have less severe symptoms, and typically require less intensive levels of care.
  • Patients range in age from infants to 90 years of age. Most patients are between 50-60 years of age.
  • WMC has reported 2 COVID deaths in the past three weeks.
  • The number of patients in the COVID Virtual Hospital have been increasing by four each day.
  • ARHS is competing with hospitals across the country in recruiting additional staffing resources, including nurses and support staff. On-boarding typically takes 3-4 weeks.

Hospital Capacity and Supplies

  • WMC has twenty-five isolation beds for COVID patients. Through a Centers for Medicare and Medicaid Services (CMS) 1135 waiver, WMC has the ability to increase the number of beds available to care for patients with COVID and non-COVID related conditions.
  • WMC has space that could be converted for additional COVID units, however more ICU-level trained staff would be needed to manage the units.
  • WMC has 20 ventilators.
  • Leaders meet daily to discuss how and where to expand capacity if the surge continues.
  • ARHS continues to monitor supplies to mitigate any shortages that may be encountered.

Our Challenges

  • As with many hospitals across the U.S., ARHS staffing is at a critical level. There are not enough ICU-level trained medical professionals to care for the current surge of COVID patients.
  • Staff are working longer hours and covering more shifts.

Outlook

  • ARHS anticipates an extreme increase in Emergency Room volumes as students return to class the next few weeks. As of August 18, 2021, the CDC reported that only 8% of individuals aged 18-24 have been fully vaccinated.

For the most up-to-date information about COVID precautions, visitor restrictions, obtaining medical records and more, visit apprhs.org/covid19

 

Masks required inside all ARHS facilities

Masks required inside all ARHS facilities

Updated July 23, 2021

 

Please wear a mask inside ARHS facilities

To comply with federal and state regulations, Appalachian Regional Healthcare System (ARHS) requires masking by all employees, volunteers, patients and visitors in all facilities, regardless of vaccination status. For the continued safety of our patients and visitors, all employees, visitors and contractors should continue to mask when in hallways, public spaces, and patient care areas.

Covid positive cases and hospitalizations have risen in the High Country and face coverings have been proven to slow the spread of the disease, including the Delta variant, which we are seeing in our community according to AppHealthCare (Health Department).

 

Protect yourself with the COVID-19 vaccine

Vaccines are readily available throughout the community. ARHS has Moderna and Johnson & Johnson vaccines available. Adults age 18 and older are welcome to request an appointment online or walk into one of the following clinic times. Scheduling an appointment is preferred.

Emergency Department Staff COVID

Emergency Department Nurses practice COVID-19 precautions

AppFamily:

  • Wednesdays, 3:30pm-6:00pm
  • Saturdays, 8:30am-11:00am

Baker Center:

  • Thursdays, 10:00am-4:00pm
  • Saturdays, 8:30am-11:00am