Jefferson Health Executive Vice President and CIO Nassar Nizami worked with his team to help the health system overcome big challenges when COVID-19 cases surged in Philadelphia earlier this year.
Now, he faces a new set of challenges to support the health system's needs. Here, Mr. Nizami discusses his team's current goals and how priorities have changed given the new financial realities for health systems across the U.S.
Question: What are your biggest challenges as CIO of Jefferson Health and how are those different from the challenges you faced earlier in the pandemic?
Nassar Nizami: We are getting a lot more face time than we used to before the pandemic because we are using Team meetings or Zoom calls to stay in touch. But there is a sense that we aren't connecting on a personal level with hallway chats, lunch breaks and other encounters, and we are feeling that loss. So, the challenge is, how can we stay connected in that way? We like to show up in the office, but we are learning to manage remote work out of concern for our people. One of the challenges is managing a remote workforce effectively. Productivity is as high as it has ever been, but the connection with employees has changed.
Q: What other changes have you seen since the pandemic began?
NN: There are three areas that have changed: our learning through the university went completely online in March; the second is telehealth, and like other systems our telehealth calls rocketed during the pandemic; and lastly, troubleshooting remote work for our teams as well as our partners. The other big challenges that existed before the pandemic but became more significant are cybersecurity and cost reductions.
Q: How has cybersecurity changed?
NN: Cybersecurity has always been important, but the pandemic elevated it as a priority. We had to leave the physical office so quickly and were forced to make certain decisions as people went remote. The priorities in cybersecurity changed because the needs of our employees and the organization changed. We had to manage equipment differently and make sure it was secure. Then we had to tackle how to address folks working from home and managing the digital front door while also making sure their communication was secure.
We are looking at a more permanent work-from-home arrangement, which could be a financial savings in rent and real estate. That's a new initiative and will lead to cost reductions. IT is a partner in that area.
Q: What other cost-reduction initiatives does IT have a role in?
NN: Robotic process automation again was an initiative prior to COVID-19, and post-COVID the need has increased 10-fold. We are looking at contracts. There is a lot more receptiveness from the organization in the post-COVID environment to slow down or cut initiatives, but if we can generate savings there is an opportunity to expedite initiatives with a clear return on investment.
At Jefferson, like some other organizations, we decided not to furlough our labor force. It was a tough decision financially, but we made the decision based on our mission and vision. Then we had to look at the costs not associated with labor and figure out how to move forward. Jefferson took a very people-centric approach and decided to resort to cost-reduction options that had the least impact on the workforce. I don't know what the future will bring, but so far, we've been able to put people first.
Q: How has the pandemic altered your short-term goals?
NN: My short-term goals have not changed, and the organization's goal for growth and great patient care is still the same. However, the tactics we're using to reach those goals has changed. We need to figure out how to position ourselves for long-term or permanent remote work. That is first and foremost an EHR concern, but there are critical pieces of IT that have to support more infrastructure. When COVID hit, things happened so fast and people took their equipment home. At the time, there was at least a tolerance of inefficiency. But when you think about working from home permanently, and the face that customers working from home as well, there is less patience with those inefficiencies.
We also need a long-term infrastructure for online learning. Our teachers were using Zoom and those technologies are not necessarily suitable for long-term teaching. Finding a more sustainable solution is a key goal for us, as well as enhancing and providing online jobs using virtual reality technology.
Telehealth is another area we want to improve upon. Our telehealth platform was good enough prior to COVID that we could scale and elaborate on it during the pandemic. We can now connect telehealth with our EHR. As the number of calls from patients increases, we need to prepare to handle a higher volume in the long run. In the first few months of the pandemic we went through a reaction period, and then stabilization; now we will change our long-term goals based on our changing business model. In the next four to six months, I think we'll be over the hump.
Q: How has the pandemic changed what you need from your team, and what your team needs from you?
NN: The largescale remote during the pandemic is somewhat new to us and I think we were able to learn that we could make very quick decisions. That is what I need from our team. What they need from us is quick decision-making, which is something our system does very well. There is a trust we have with one another that different teams are doing the right things to get the job done.
Our first priority is keeping our teams safe. COVID-19 isn't spreading in our region and cases have gone down, but there are still cases every day and there is still a negative impact. There are still a number of folks on our team that have to go to the hospital every day and we aim to keep them safe. We also need to maintain our nimbleness and ability to execute while working from home. Our team has responded in an outstanding manner and we were able to deliver to the organization a seamless experience during a difficult time.