10 things for CIOs to know as COVID-19 spreads, and recovery planning begins

Health systems continue to grapple with the clinical and financial implications of widespread COVID-19 cases, with a new focus on preparing for the future.

Health IT leaders are collaborating to open field hospitals and work together on technology that will track the symptoms and spread of COVID-19 after stay-at-home orders are lifted and states reopen. Big tech companies are making even more data available than in the past to help health systems plan for resource allocation in the future, and new cybersecurity threats are emerging.

Here are 10 things for CIOs and health IT leaders to know.

1. The field hospitals in New York City, Chicago and New Jersey are deploying Epic EHRs, with the tech giant providing services and support at no cost. In Chicago, Rush University Medical Center teamed with the Chicago Department of Public Health to create a 3,000-bed COVID-19 alternate care facility at McCormick Place Convention Center, and Epic provided the software. New York City also deployed Epic for its 1,000-bed temporary hospital at the Javits Center through a partnership with NYC Health + Hospitals. In New Jersey, Epic partnered with University Hospital to turn the Meadowlands Exposition Center into a healthcare facility, providing staff that have experience installing technology for field hospitals in preparation for surges across the country. The installation project took three days.

2. Amazon Web Services made its COVID-19 data lake available to the public on April 8 to support hospitals, researchers and public health officials. The data lake is a centralized repository of curated datasets related to COVID-19 and its spread, including data from the Johns Hopkins and The New York Times data lake as well as health data from Definitive Healthcare and 45,000-plus research articles from the Allen Institute for AI on COVID-19.

3. While many health systems are scaling their remote work capabilities, the IT team at Dover, Del.-based Bayhealth said they are required to still go into their offices at the Blue Hen Corporate Center. The Dover Post reported that around 150 employees are still working in the office, although their source said the IT jobs could be done remotely. The IT workers raised concerns about increased risk of exposure to COVID-19 while working in the same office space.

4. The FBI warned hospitals and health systems that the operators of Kwampirs Remote Access Trojan, a hacking group, are using malware to gain access to hospital machines and networks. The goal is to exploit the hospital's computer network, and the group is targeting healthcare, software supply chain, energy and engineering industries. The FBI said the group has conducted effective attacks on hospitals and health systems, gaining access through vendor software in the supply chain and hardware products.

5. Big tech companies and health systems are working on initiatives to track COVID-19 community spread. For example, Rochester, Minn.-based Mayo Clinic created an EHR tool that alerts staff members who may have been exposed to an employee or patient that tested positive for COVID-19. The San Francisco public health department established a task force to develop an online app that will trace the interaction of people who tested positive for COVID-19. On April 10, Google and Apple announced their partnership to develop APIs to track COVID-19 spread through smartphones. Users opt-in to the APIs, which are expected to be released in May, and will track people who have come in contact with patients that tested positive for COVID-19.

6. Although hospitals are losing revenue due to the cancellation of elective procedures, they continue to make investments in digital health and data analytics companies. OSF Ventures, a division of Peoria, Ill.-based OSF HealthCare, joined a $16 million investment round for SilverCloud Health, a digital behavioral healthcare solutions company. Existing investors included MemorialCare Innovation Fund and UnityPoint Ventures. Urbana-Ill.-based Carle Health announced a multimillion-dollar partnership with Health Catalyst on April 14 to improve data and analytics solutions at the health system. There are nine other key digital health and telehealth start-ups raising millions during the COVID-19 pandemic.

7. HHS decided to distribute the first $30 billion in emergency funding to hospitals based on Medicare fee-for-service revenue, and hospital CEOs aren't happy about it. The agency said it would allocate money to hospitals based on historical revenue from the Medicare program instead of by the burden caused by COVID-19 or the number of uninsured patients treated at the hospital. The CEO of the Greater New York Hospital Association, Kenneth Raske, wrote a memo to members saying that the method would be "woefully insufficient" to address New York hospitals' financial challenges and Jackson Health CEO Carlos Migoya said the distribution method "could jeopardize the very existence" of the hospital. See the state-by-state breakdown of federal aid per COVID-19 case here.

8. Health systems continue to project huge losses amid COVID-19, the most recent being Rochester, Minn.-based Mayo Clinic. Mayo projects a $900 million shortfall and said systemwide pay cuts and furloughs won't shore up the difference. The health system reported operating at 35 percent capacity and surgery at 25 percent capacity as the nation turns focus to treating patients with the coronavirus. The system has protected employee pay through April 28 and will have to institute pay cuts and temporary furloughs at that point. CEO Gianrico Farrugia, MD, took a 20 percent pay cut at the beginning of April, and physicians as well as senior administrators will have a 10 percent salary cut.

9. The White House froze funding to the World Health Organization on April 14, pending an investigation. The country aims to work with WHO to make "meaningful reforms," according to President Trump, and the American Medical Association issued a statement asking the president to reconsider this decision.

10. Governors on the East and West coasts have issued plans to reopen the economy. New York, New Jersey, Connecticut, Pennsylvania, Delaware and Rhode Island governors are developing a coordinated strategy to reopen the economy and develop the framework to gradually lift the stay-at-home orders. Governors of California, Oregon and Washington are engaged in similar efforts to reopen their states. The efforts to reopen the economy will require technology to track the symptoms of individuals and spread of COVID-19, blood testing for antibodies, cashless transactions and widespread use of face masks and face shields.

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