Health systems around the U.S. are reporting significant revenue declines due to the COVID-19 pandemic. But many also see IT projects as crucial to providing patient care.
In many cases, health systems are continuing to invest in EHR implementations and upgrades, although some have shifted go-live dates to focus on the emergency at hand. Many CIOs also report critical investment in data analytics platforms, telehealth and virtual work capabilities long term.
Here, 13 CIOs and CMIOs outline the projects their teams are moving forward with, despite the pandemic.
Eric Neil. CIO of UW Medicine (Seattle): UW Medicine has been an ambulatory and revenue cycle Epic customer for a long time, and we are in the middle of a project to expand our Epic footprint into the inpatient and ancillary departments across our hospitals. We are not going to stop this project; our experience with COVID-19 has further cemented our commitment to give our providers a single EHR with standardized and improved workflows. We owe it to them, now more than ever. We did, however, move to a mostly work-from-home project team, switched our go-live date from October to January 2021, and we are making adjustments to use virtual solutions or otherwise ensure physical distancing during user acceptance testing, demos, training and go-live support.
Jesus Delgado. Vice President and CIO of Community Healthcare System (Munster, Ind.): We are fast tracking out implementation of telemedicine. During the next couple of months we are going to be onboarding hundreds of physicians. We are also enhancing out telemedicine by incorporating remote patient monitoring devices with full integration to our EMR.
We are realigning and reprioritizing our data analytics projects. There is already anticipation that we will have COVID-19 back in the fall. We want to have better data-driven insight into our patient population specific to COVID-19 symptoms.
We are also going to be focusing on IT projects that can present opportunities for cost savings or operational enhancements that can lead to better cost management. COVID-19 presented the healthcare industry with tremendous shortages in revenue and we now need to see how to recover from the financial pressures.
Scott Kelly. President and CEO of Asante (Medford, Ore.): We are just now turning our attention back toward the large stack of strategic projects waiting in the wings. The challenge will be to continue to provide the right amount of attention to COVID-related planning and support while increasingly working on backlog as opportunity permits. In point of fact, all of our enterprise ITS initiatives have a clinical, operational or financial consequence if they were to be canceled. We can and must move forward.
However, we also recognize that it's not business as usual in this COVID and post-COVID world, so I’m emphasizing clarity around prioritization for the team. Recognizing that there are finite resources to implement large bodies of work, we are categorizing each project as:
(a) fixed timeline (COVID irrelevant)
(b) can be pushed out three to six months and
(c) projects which are more discretionary.
We have to remember there are hard dollar consequences if we don’t proceed on many of our projects — such as Imaging CDS, lung cancer screening, MRI, new construction and others.
Mark Lauteren. CIO of El Centro (Calif.) Regional Medical Center: The projects we are still planning on post-pandemic include:
· Keeping the lights on infrastructure projects
· Information security enhancements
· Business continuity enhancements
· IS governance enhancements
· EHR upgrades that are regulatory required
Curt Kwak. CIO of Proliance (Seattle): We continue to focus on the critical projects and those 'true' value-add projects that will optimize the new and adjusted workflows, process constraints and ease the navigation for our clinicians. We also have adopted new processes to align with the COVID-19 restrictions, including expansion on telehealth and other virtual services we can efficiently provide to our patients. The bigger initiatives that will take some time for the organization to benefit the current adjusted models are being paused until we are able to get back to normal staffing levels and a more consistent business cadence is established. We are fully aware that we are currently living in extraordinary times and things are hard to predict, so we continue to focus on those that we are very certain and quickly will have direct benefit to the organization.
Mike Russell. CIO of Shannon Medical Center (San Angelo, Texas): The primary project we are working on is the acquisition of the Community Medical Center, which was announced April 20. This could be the largest project that we have undertaken here at Shannon since I’ve been here 20 years. This will likely consume the majority of our time over the next six months to a year and rival anything we have done before in complexity and detail.
We are also continuing with our scheduled Epic quarterly upgrades after delaying for one month due to the COVID concerns. If things get worse, we thought it would be best to be as current as possible in case there was a longer delay in future updates.
IT is still working on transitioning to Windows 10, which is taking longer than anticipated. We hope to have that wrapped up before we bring the newly acquired facility online with Shannon.
Management of remote employees' productivity became a larger issue with COVID and we are working on improved ways to measure productivity and ensure staff working from home can communicate and interact smoothly with those still at the facility.
Raymond Lowe. Senior Vice President and CIO of AltaMed Health Services (Los Angeles): At AltaMed, we believe the new normal is that televisits are here to stay. Thus, we are focusing on our digital first strategy for patient care including televideo visits going live in May through Epic MyChart. In addition, we are fast tracking our overall patient experience and remote patient monitoring approach to provide care to our patients outside of our brick and mortar facilities.
Patrick Woodard, MD. Vice President of Clinical Systems and CMIO of Renown Health (Reno, Nev.): Perhaps unsurprisingly, we have spent a lot of time during the pandemic focusing on patient-facing technologies, seemingly overnight putting a laser focus on our digital transformation. With help from our partners at Epic and incredible work by our IT and clinical teams collaborating together, we were able to rapidly deploy virtual visits, patient portal enhancements and mobile tools for our clinicians. As we look beyond COVID-19, we will continue to improve these tools and add on to others in order to meet our patients where they are — whether that’s in a clinic with a mask or at home with a mobile phone.
Tom Barnett. CIO of University of Rochester (N.Y.) Medical Center: Telemedicine and patient interaction technologies and features are front and center at the moment. While we are all managing this current crisis, technologies that can keep our patients and providers connected digitally (and from a distance) are among the current focus areas.
I think it also makes sense to look closely at those projects that focus on operational efficiency or patient movement that have a relatively low cost to implement. There isn't much capital to go around at the moment, so cost-efficient quick wins can become good candidates to more closely examine with our clinical operational partners.
There are two areas that have made significant strides in both adoption and expansion in the last several weeks, telemedicine and work from home. Once this pandemic has subsided, I think everyone will look to build upon each of these programs and they will likely become more integrated and more a part of our everyday lives. These technologies have existed for quite a while, but the use on this larger scale is the real change we have seen. Along with this we need to keep the focus on security, which is something you can never lose sight of.
Darrell Bodnar. CIO of North Country Healthcare (Lancaster, N.H.): North Country Healthcare is an affiliation of three critical access hospitals and a home health and hospice agency. Each hospital brings its own set of unique service lines spanning many specialized services as well as primary care, behavioral health and substance abuse, and all the ancillary services that support it. We are also spread out across a large geographic area with many outlying clinics.
With that being said, one of the biggest challenges we face is being on separate IT infrastructures and IT systems, including our clinical systems and most importantly our EMR.
Over the past few years we have been aligned with the strategic mission to standardize and centralize all of our systems. We have collapsed many into single systems and were approximately a third of the way through a single EMR system when COVID-19 hit. We quickly adjusted our focus and attention like many others to standing up and expanding a robust telehealth and virtual care platform and paused our implementation of our single EMR that was scheduled to go live across the entire continuum of care Oct. 1. That date has now slid to Dec. 1. Our primary focus will be to continue to consolidate all our systems, both clinically and operationally over the next eight to 12 months.
John Henderson. Vice President and CIO of CHOC Children's (Orange, Calif.): We are still advancing our digital patient experience initiative. We had just launched the effort one month before COVID-19 and although we did take a brief pause for four weeks, we have picked back up and are working on our phase one deployment. We are also moving into the second phase of telemedicine, which will focus on deep integration with our EMR along with establishing virtual waiting room capabilities that will sync with our digital patient experience initiative. We are also continuing to advance our implementations of the EMR for three new primary care practices that recently became part of our network.
Linda Reed. Vice president and CIO of St. Joseph's Healthcare System (Paterson, N.J.): We need to contemplate what life will look like post pandemic. What we felt was really important last year when we started doing our capital planning, we need to examine how valid it is at this point in time. We need to reassess our plan moving forward in consideration of what the new normal will look like; how operations will behave or operate now, given social distancing. How are we going to schedule, register and intake patients? What does patient engagement look like?
We have a couple of projects involving enhancing mobility, virtual visualization within the hospital walls and optimizing telehealth. We're also going to continue working on analytics and keep our life cycle projects, so updating our network, storage and cybersecurity platforms. We were very lucky because at the end of last year we rolled out our electronic prescribing for controlled substances capability, which allows physicians to order controlled substances online during video visits. We will also enhance this capability.
Jeffrey Hoffman, MD. CMIO of Nationwide Children's Hospital (Columbus, Ohio): Fortunately, children’s hospitals are going relatively unscathed by the COVID-19 crisis. While we have had a few hospitalized COVID-19 children and more severe illness among vulnerable populations, our patients as a whole are not getting sick in the numbers and to the degree that adults are succumbing. Our primary concern – and the bulk of our organizational efforts – during the crisis have been focused on social distancing measures, in particular supporting staff via telework and patients via telehealth. Likewise, our IT focus has been in those areas alongside projects to implement rapid testing facilities on campus and COVID-19 related workflow tools in the EHR.
The rest of our IT projects are still moving forward, albeit somewhat slower in spots due to constraints with vendor and contractor availability, as well as a general loss of focus these days. Budget-wise, we are mid-year and most projects were already planned or underway when the crisis hit, so we have had no major change in our big deliverables so far. Chiefly among them is a new data center in the final stages of construction, which we will be moving to the summer. That project has already called for a drastic reduction in non-essential IT work to free up multiple teams to support the data center move schedule, so we did not see a dramatic reduction in project work as a result of COVID-19. Of course, as the crisis drags into Q4, I'm certain it will be a factor in both budget and project decisions for next year.