Date: 06/12/2019

The Hopkins Access Line (HAL) organizes admissions throughout the Johns Hopkins health system, including transfers between Johns Hopkins hospitals. 

HAL, which is part of the Judy Reitz Capacity Command Center, receives about 60,000 calls a month and facilitates admissions of about 900 patients, says Kimi Kobayashi, medical director for HAL and associate medical director of the command center.

Johns Hopkins doctors — as well as physicians from other medical centers — can begin the transfer process by calling HAL (800-765-5447) 24 hours a day. They will immediately speak with one of the 16 coordinators on staff.  

The coordinators connect the referring physicians to the appropriate admitting doctors and work with admitting, bed management and Lifeline Critical Care Transport if needed.

“If referring doctors don’t go through HAL, they would have to find a doctor to accept their patient, and that person would have to find a bed and make the arrangements for admissions,” says Kobayashi. “That’s all stuff that physicians, in my opinion, should not be doing. We want to make the process as streamlined as possible.”

Though the coordinators are not physicians, “they have a deep understanding of how our services and systems work,” says Kobayashi, a hospitalist in the Department of Medicine at The Johns Hopkins Hospital. 

Coordinators also know where beds are available because they are part of the command center, a high-tech nexus for managing hospital capacity and patient flow using real-time and predictive information.

When referring physicians call, the coordinator asks a few questions to determine the best course of action, and then pages the appropriate doctor on call in order to explain the situation and provide bed availability information. The doctor on call is then connected via HAL to the referring physician, so the clinicians can decide on the best course of action for the patient.

HAL, created in 1992 to facilitate patient transfers from community hospitals to The Johns Hopkins Hospital, was expanded in 2016, when the capacity command center opened. It now organizes admissions throughout the Johns Hopkins Health System, says Kobayashi.

“Historically, when a patient needed more care, it was always at The Johns Hopkins Hospital,” says Kobayashi. “Now, we have specialized services at multiple campuses. We can use all the resources available to us, across the health system.”

By connecting referring physicians to specialists, HAL ensures patients get the care they need. HAL coordinators can also connect a primary care physician with a dermatologist, for example, to discuss whether a rash is serious enough to require hospitalization or an emergency department referral. “The goal is to match the patient’s needs with what we offer within the Johns Hopkins network,” Kobayashi says. 

HAL coordinators can also arrange for patients to return to originating hospitals after an evaluation or procedure at a Johns Hopkins hospital. “We can now do a round trip, where the patient gets a specialized scan, surgery or evaluation and then goes back to his or her local hospital,” says Kobayashi. “I’d like to see us do it more because it returns patients to their communities.”

“I really encourage our doctors to leverage the expertise of the HAL coordinators,” says Kobayashi. “It’s beneficial to the entire health system because it helps manage capacity and connect patients with the right Johns Hopkins resource, and it’s beneficial to the doctors because it streamlines the process of transferring patients.”