Hello, everyone. This is Jacob Emerson with the Becker's Healthcare Podcast. Thrilled today to be joined by Colin Lane, who's the senior vice president of ancillary, shared services, and facilities management at Atrium Health. Colin, thanks so much for taking the time to be with me on the podcast today. Glad to be here, Jacob. So, Colin, before we dive into everything we wanna talk with you about today, can you tell us a little bit more about yourself, your background in health care, and what it is that you do today at Atrium Health? Yeah. Sure. Let's see. So where to start? I started, I've got a master's of science in public health and epidemiology from UAB. I have a master's in health care administration from UNC Chapel Hill. I have been with, Atrium, now Advocate Health, for now 20 years. I started at Deloitte Consulting, doing strategy and ops consulting in the health care practice, doing mostly payer work straight out of grad school. And then, came to what was then Carolinas Healthcare System, and we became Atrium Health and now Advocate Health. I've done various roles running service lines, building new service lines, running hospitals, groups of hospitals, ran all of our hospital based ambulatory assets, built up our post acute platform, took on the facilities management role in addition to my other, you know, clinical and operational responsibilities in about 2017, and I'm currently leading a lot of the project work that some of which we'll talk about today. Fantastic. So a long career, it sounds like, with Atrium and Advocate, Colin. With with that, let's talk about a recent milestone that the health system recently reached at the Atrium Health Carolina's Medical Center and the construction of a new advanced care facility at the at the flagship hospital in Charlotte. Tell us a little bit about this facility. What's the timeline here? What's the vision behind this new facility? And, ultimately, how does this align, Colin, with with Atrium's work to improve access to care for the growing population in your market? Yeah. So, that's actually been a project that I've been on since 2017. So we've got a lot of taking a lot of licks on this one. The, you know, I I'll give a little kind of 30,000 foot background on the project. So, you know, Jean Woods, our CEO, came in about 2016, 2017. So we had a major transition system leadership. We also had a really growing market in Charlotte. And with that aging facilities, the demand for tertiary quaternary services in the market growth and just the broader market growth, compound annual growth really just kinda created almost a burning platform to need to address that facility. It's really our flagship in the market. We run over a 1,000 average daily census there between peds and adults every day. But to give you a little background on the facility itself, so North Carolina was actually the largest beneficiary in the 19 forties of the Hill Burton Act. So it's kinda World War 2 going on and people coming back, and there's obviously, there weren't enough hospitals per capita across the market. North Carolina became the largest beneficiary. And so that's actually when a lot of our hospitals, even across all of North Carolina, were kind of built in the forties. And so you've got facilities that were kind you know, continued to be, you know, be about 80 plus years old and so needing, some significant investment. You know, we've made, you know, ambulatory investments across primary care, specialty care, and just with the increasing utilization and average daily census, it just it just was a must do project. We really needed to replace the majority of the infrastructure for that campus since it was built over 80 years ago. And then every addition that was done since 1940 kinda perpetuated the original shortcomings of the facility. So we had really low floor to floor heights, floor to ceiling heights, just the the campus power, the ability to manage new square footage, fiber, keep up with kind of the new equipment demands, it really became a major barrier. So, we really had to replace, and add all of our high end capacity. So that meant redoing all of our operating rooms, all of our procedural space, all of our imaging, our emergency department, building capacity for the emergency department that, you know, is really greater than a 120,000 visits a year. We also needed to build high acuity rooms to keep up with just the increasing quaternary demand of the market. We've made significant investments in our physicians and specialty infrastructure, so across all our specialty programs like cancer, heart and vascular, neurosciences, musculoskeletal, general surgery and transplant, pediatrics. So we really needed the facilities to keep up with the increasing complexity of care the patient needs, but also just the level of talent that we have brought to the market. And just with those continuing compounding acuity rise, and just the need for can you know, that ad for technology, the facilities need to be able to keep up. And so we just, you know, kinda made the decision that when you build a hospital and really build a facility of that size and scope and scale, it's not it's not just a 20 year investment. I mean, it's really a 100 year investment. So we we really tried to think cohesively about our broader master facility plan and that this was a major kinda cog in that wheel to get to kinda build that campus for the future. Sure. Absolutely. It makes complete sense in terms of the the population trends and the aging facilities you were you were looking to address. You mentioned the size and scale of this project, Colin. It's an over 1,100,000 square foot facility. It's massive, as you know. So with the project of this scale, what were some of the key considerations in terms of budget allocation for the health system and then, ensuring a strong ROI for Atrium overall? Yeah. Well, it this was a tough one. Right? So now granted, we started planning in 2017, and so a lot changed over that time period. But first, this was really a project that we considered more of a replacement. We wrestle for years about what the appropriate pathway was. The problem was is based on what I said earlier, it was really became a must do. The alternative of doing nothing or just leaving the current state really wasn't feasible. I mean, we've got a significantly growing market. We had growth in the tertiary demand, and we felt the risk of not doing anything was way greater than, doing this big project. And this is a multi component project that there were actually a lot of sequential components that had to happen over time. And and by the time we're done, it's gonna be 10 years in the making. You know, it was critical for us to kinda track how we would expend those cash flows knowing that we were kinda paying out of operating reserves. It was a long tail on the project, so we're pretty strategic about when we did the buys and when we did the, build and how exactly we sequenced it. But a project of that scale is definitely a it's big. Now granted the system's gotten bigger, in the Advocate Health kinda platform, and so that, you know, kinda brought a little more stability to the to the overall financials of a project of that size and scale. But it you know, it's a it's a great market. We're I think it's doing the right thing for our patients. We are the the safety net provider. So it really this was kind of a must do just to meet the broader market needs, but also to kinda keep up with with really that kind of scale of being the, you know, high-tech, high touch partner in the and provider in the market, and knowing that we're we're really attracting a significant amount of talent in the high in the in the specialty space. And in order to do that, you really have to provide the best facilities. So that was kind of the those were the major, you know, considerations, but we were able to kinda do it over a really long time, period of time. Absolutely. And you mentioned you started this all back in 2017. Obviously, the world health care has has gone through a lot since then. So what was what have been some some of the biggest hurdles since construction began, during construction, and, ultimately, how has Atrium address these to keep things on track? Yep. Well, so first and foremost is, you gotta build the best team on the front end. So you, you know, you go slow to go fast. So we were very conscientious on the front end about picking the right partners because that's how you're gonna mitigate risk. So, you know, I embarked on trying to hire talent bring talent into the market to help manage these projects. So bringing talent onto the team that could manage a, you know, a 1,000,000,000 plus dollar project. Then it was you know, we picked very, intentionally our partners, our architects, our GCs, our engineers, our you know, who is gonna do the steel, what your steel fabricator, etcetera. So we were very intentional so that we had a kinda multidisciplinary team. We also brought in some third party project, project management, capability that had some experience on 1,000,000 plus square foot projects. But that team worked really well together, even with in the throes of some of the big challenges that we came up with. So a couple of comments about the complexity of the project is there are a lot of dominoes that had to occur sequentially to even execute this. That meant that there are a lot of enabling projects. And so we actually had to move the school health sciences, which is our allied health program, and a local teen pregnancy and foster child program. And what does that mean? That means we had to build a new school and a new, foster child program and teen pregnancy program facility before we could shut those down and tear them down. That we also had to we had to tear those down so that we could build a brand new rehabilitation hospital because the old rehab hospital that had been built in 19 fifties was where the new tower was going. We also had to build a new parking deck before we could take the old one down to make way for the new tower. So we had all these sequential enabling projects that were in the several $100,000,000 range before we could even start, on on the big tower. Now you throw in the complexity of of COVID, the rapid escalation that we experienced during that period. On top of that, just broader labor market issues and deficiencies, shortages in the trades because of broader market demand, because there is a lot of big, you know, buildings being built, in office, a lot of multifamily. So it took a lot of the submarket, capacity. You know, that that created a lot of challenges. And so the escalation alone over you know, really, we've been working on this project for 7 years has been pretty tremendous. And so we we had to constantly reengineer scope and rethink, really the timing of how we were gonna execute some of these components to meet the cash flow needs of the broader organization, but also to make sure the project was even feasible to execute. We were able to leverage prefabrication in a really big way to mitigate some of these factors. So that took, again, that kind of team that we built on the front end to get really creative. So we pre fabricated all of our mechanical racks, the mechanical, which is, you know, mechanical, electrical, plumbing, HVACs, mechanical. All that was a really major component that we needed to prefabricate. So we prefabricated all the mechanical racks for the entire tower. We did the same for the rooms, on the head walls, bathroom pods, a lot of the skin of the building. All that was prefabricated. So we were to kinda keep everything on track, but it it took a very much a team effort and a really strong team that we built on the front end. Wow. So so clearly a a campus transformation that had to happen before the new tower could could be completed. And and, Colin, when do you expect that to happen, that the new facility to be to be open to patients? Yeah. So, so we actually so we opened the rehabilitation hospital 2 years ago. We built a new deck that we opened in early 23. We, started the steel early 24. We just topped that off, and then we will open for patients in middle of 2027. We also obviously still have other campus work. We redid a greenway that was adjacent to the campus. We rebuilt the bridge for access, retooled all the roads, and have made some other investments in our energy plant to update those facilities. So all that will kinda come in in 2027. Understood. And so when when all is said and done, Colin, what do you anticipate the biggest impacts will be for Atrium in terms of operational efficiencies and and patient care delivery stemming from this new facility? Yeah. I mean, you know, broader Advocate Health, Atrium Health. I mean, we're this is a community, you know, benefit driven organization, And so we're typically the largest employer, the safety net provider, but also the high acuity, the the highest complexity provider in the market in both acute and ambulatory services. And so, you know, really, this building was just one project among many. We're doing the same thing at Wake Forest at Wake Forest Baptist. And I can name other projects here for you. But, I mean, it was aligned with what we were trying to do in the market. This is obviously our flagship facility. We have the Charlotte market services, both state of South Carolina, Georgia, all over North Carolina. So we have patients coming in from all over. And so we we've got to continue to make investments in that, in that chassis, and and provide those services, especially given that, you know, we built up all these other specialty programs that I referenced earlier in cancer and cardiac and pediatrics. I mean, we're typically the number one provider in all of those specialties in both acute and ambulatory in that market. So, you know, we'll we continue to enhance those tertiary and quaternary capabilities. It's also aligned with our academic and research platform. So we're also a teaching facility. And so our facilities kinda have to match that level of expertise as well as the demand for higher end services. So the only way for me to offer the latest and greatest in any specific, you know, cancer or cardiac or any of the, you know, intraoperative MRI, some of these some of the robotic platforms that are out there, we we had to do this project, and that's just kind of what we we need to do for our community. We we were very cognizant, though, that we needed to consider to be the hospital of the future. And we've designed it for virtual care capabilities, EICU, virtual nursing, to leverage robotics and then the procedural space, leverage artificial, you know, AI integration for a lot of these platforms. And so that's kinda really what that's really what we've done. But we've also built it with the intent that we can upgrade it in the future. So as upgrades are necessary in the inpatient rooms, the procedural space, etcetera, we can easily accommodate that. Absolutely. It's really, really interesting to hear about the the forward thinking of this facility as well. But before we go, Colin, what else are we missing? Any other final thoughts or bits of advice you wanna offer, to all the other health system leaders listening in? Yeah. I mean, I think, you know, we've got, just first of all, just Charlotte's obviously a growing market. And, you know, we built not only this big bed tower. We we've got 2 greenfield hospitals that we're bringing to the market. 1 that we brought in late 22 and another at our Lake Norman campus, that will open, in June of 25. Yeah. We we've got we're we're managing across a really big platform, so we're making investments in Greensboro, North Carolina with a new greenfield hospital. So we've really tried to focus on building prototypes, being able to do things for, you know, cheaper, faster, better, which used to be in contradictory to each other. But, actually, now with given prefabrication and a lot of technology, you can actually you can actually accomplish all three of those. So we're really trying to be you know, bring things to market that the patients need and the communities need, but also leverage that scale to do it efficiently. We've made tremendous investments in our academic and research program. We have the Pearl, which opens next year. That is really gonna be the where our new medical school will be. Obviously, that's a major attractant for talent. We've got our allied health program that'll be collocated, and really kind of building an innovation district around that and what role we in the health sciences can play in market innovation and product innovation. Actually, you can we can really lead the way as major health systems, and we can leverage those assets in academics and research to partner with industry, which is really what we've done with our earCAD platform. That's our surgical training, and device and product development, and adoption platform, that we partnered in France. So that'll be ERCAD North America. We'll be based here in Charlotte. And then partnering with other other industry like Siemens on, you know, the latest and greatest in the imaging space and how we can do use those applications in product development, partnering with Stryker, Boston Scientific, and others, and and really trying to do the right thing for patients, but also leveraging the skill sets of our providers and academics and research, to build a better mousetrap for the future. But, yeah, there's there's a a lot going on in the system and lots of opportunity, and if, you know, we we are able to leverage that scale for for doing, you know, the right thing in our communities and and really trying to build a a better way to do things. Absolutely. Well, clearly, a lot of exciting things in the works and and on the horizon for for Atrium and advocates. So, Colin, thank you so much for taking the time to sit down with us and for sharing your thoughts with our audience. We really appreciate it. Thanks for having us, Jacob. If you'd like to listen to more podcasts from Becker's Health Care, you can visit beckers hospital review.com.