Healthcare IT leaders are finding ways to continue innovating as hospital and health system budgets shrink as a result of the COVID-19 pandemic.
At the Becker's Healthcare Health IT + Revenue Cycle Management Virtual Event, two panelists discussed how to stay at the forefront of patient care and data analytics on a budget. The panelists were Esteban Gershanik, MD, a physician, informaticist and consultant for Brigham and Women's Hospital in Boston, and Andrew Chang, MD, chief intelligence and innovation officer and medical director of the heart failure program at Children's Hospital of Orange County.
Editor's note: These responses have been slightly edited for clarity and length.
Click here to view the full presentation on-demand.
Question: How has the pandemic affected your IT budgets?
Dr. Chang: I think we are still in the throes of the pandemic, so it's hard to see what the end result will be, but fortunately we started off in a reasonably good position, but we won't be able to take on new projects in the next six months and we'll try to accommodate the tremendous need right now we have for the hospital. I work in a children's hospital so we don't have the volume of critically ill patients that we're seeing in the adult hospitals yet and hopefully we never will. But we do have many issues like telehealth visits that came up. We went from a relatively slow escalation prior to COVID to an exponential rise in the number of visits – went to 25-times more visits in about a month, so that's been the biggest strain on the IT infrastructure.
Dr. Gershanik: Similar to other hospital systems across the country, a lot of us are experiencing difficulty with a lot of need for all of our departments, not just IT, so all of us are looking at things in a smarter fashion. The one thing I've seen at our hospitals is some difference in demographics that we see traditionally in our hospitals in addition to virtual care. What we are trying to do is take a smarter approach to how we both look at our data and implement expansion of some of our IT systems. One of our things that we weren't as critical at looking at before was looking at not only things that went around different patient populations but things that went around expansion of operations and even interpreting services for the demographics of patients that come in. So integrating aspects of iPads and the needs of the population, we saw a change during the COVID-19 pandemic.
Q: What are one or two key takeaways about IT on a budget and staying on the forefront of analytics and patient care?
Dr. Chang: Don't have unrealistic expectations of analytics and artificial intelligence. It is data science; it is very capable of helping, but it shouldn't be the end all be all. There is even discussion in the media about how disappointing artificial intelligence has been in dealing with the pandemic. But it's only as good as the data and the data science, and what it can do in countries like ours, which hasn't done well in the area of public health interventions and with bad public health interventions you cannot make up that deficit with even the best of analytics and technology.
It reminds me of how we deal with health in general in the country; we don't try to deal with the epidemic of obesity but we are very good at putting in a coronary stent, and treating coronary artery disease is among the best in the world. So we have to couple public health intervention with technology that we have to have the best of both worlds. Countries that have done well with the public health interventions have deaths in the double-digits and that's something we need to learn form.
Dr. Gershanik: One of my colleagues used to say that innovation is looking at problems through various lenses. I think the more representation that you have around and create your data analytics will be at the forefront of ensuring a solid foundation to push some of those things forward. There is still a lot we don't know and what this pandemic has done is put a lot of institutions on a fast forward pace around remote monitoring, virtual visits and seeing how we work around healthcare delivery outside the walls of our hospital systems.
We also have to think about family members as well. Many of these patients were dying without anyone around here and in isolation. The more we have different people around the table, the more we can take a holistic view of how to address the HIT issues we have at hand and some of that is really looking at the operations, being as lean and smart as we can and organizing things before we implement. If we rush to implementation and don't take the time to look at things through the lens of various people, we will do a disservice for the implementation and strategy. The more cohesive that we are with a broad perspective and various eyes looking at the problem, the more we can create the solid foundation of data and structure and data elements to collect patient information both clinically as well as around the social determinants of health, the IT needs and other components that make up that individual and population and the needs we can implement and integrate form a healthcare system.