The U.S. health system is going through seismic changes in response to the COVID-19 pandemic.
Across health systems, executives including CIOs have pivoted their focus to support their teams remotely and caregivers as they treat COVID-19 patients. Here, CIOs from hospitals and health systems in a few of the states hardest hit by the pandemic so far outline their top priorities and key advice for their colleagues preparing for a surge of coronavirus patients in the coming weeks.
Jeffrey Sturman. CIO of Memorial Healthcare System (Hollywood, Fla.): My top three priorities are:
1. Enhancing and rapidly pushing out our existing telehealth capabilities while also developing new way to communicate with our patients.
2. Helping to coordinate consistent and constant communication with our patients and consumers via any and all technology means; that includes websites, text, email, bots, telephone and even manually while also helping to facilitate communications to our internal healthcare staff, through video conferencing and all other traditional means.
3. Designing automated screening, scheduling, and results notification processes with our local, regional, and state representatives in the testing of COVID-19.
Key advice: We all need to remain extremely flexible in these uncertain times. We need to continue to do the 'magic' behind the scenes in keeping our systems up a running. We also need to be as proactive as possible, for example by addressing network bandwidth, and making sure what is typically not a remote working staff are able to do their jobs in a secure and effective way.
We are used to running projects across our diverse settings. Our IT teams are oftentimes helpful in coordinating and facilitating major initiatives and we are certainly in the midst of major activities with dealing with COVID-19 and IT can help keep things controlled. Finally, we are all in this together, and we have a lot of highly qualified staff that can support those areas in our hospitals that are not traditionally IT functions, but in emergent situations we all can play a role.
Tom Andriola. Vice Chancellor of IT and Data at UC Irvine (Calif.): Our top priorities are planning for the expansion and resiliency of services during the pandemic; keeping our employees safe; contributing our deep clinical expertise toward research and clinical trials around the virus.
Key advice: I think people need to have access to as much information as possible in times like these. People tend to simplify things down to keep them manageable as well as to help them deal with the complexity and uncertainty. Giving people lots of opportunity to hear information, ask questions and help connect the dots across the organization is always important as a leader. What's different right now is these two things; first, how rapidly the situation might change because of new numbers, a government decision, or the general uncertainty around COVID-19. We're literally dealing with a dramatically changing environment every day, which makes planning extremely difficult. Second, it's important to help people with the challenge of getting credible information. They look to leadership and inherently trust that the information they're getting from us is both timely and accurate. We can't lose sight of that. So basically, it means doubling down on information sharing and creating opportunities for conversation and learning.
BJ Moore. Executive Vice President and CIO of Providence (Renton, Wash.): We are starting to see the benefits of the progress we have made standardizing our systems and tools, moving to the cloud and simplifying the environment. Having most locations on the same instance of Epic, for example, has been critical in helping us drive rapid response to changing needs. Having Office 365 and Teams rolled out to the majority of our caregivers has also made a big difference in our ability to maintain productivity. This together with improvements in network capacity and VPN are allowing us to enable work from home for a broad range of non-clinical users.
Key advice: It is important to have strong leaders engaged across the board driving very intense coordination. In this kind of situation, it is very easy to have many well intentioned efforts at odds with each other which can result in waste of time and resources. It's important to have well-functioning command and control structures to manage the response. Also, having to enable business processes and roles that are traditionally performed at the office setting versus home has provided valuable insights for our device strategies, for example using laptops instead of desktops, and other key capabilities going forward.
Laishy Williams-Carlson. CIO of Bon Secours Mercy Health (Cincinnati): Our top three priorities to support clinical operations include (1) rapid changes to our Epic instances to build COVID-19 dashboards and registries, build or configure repurposed inpatient care units, and support changes in accessing records; (2) deployment of technologies supporting new approaches to care, such as workstations on wheels located in isolation rooms to provide caregivers a way to communicate with the patient from outside the room decreasing use of PPE; mobile technologies for patients to communicate with their families; and provider assessment of patients remotely, for example in a long-term care setting; and (3) rapid expansion of virtual visits including practice visits as well as hospital based services such as physical or occupational therapy.
Key advice: [The biggest need for technology resources and budget to support caregivers is] additional mobile devices and new configurations to support constant innovation and new use cases. The partnership of clinical informatics and IT has never been more essential to assure we meet caregivers' needs. I would also like to commend many of our vendors who have stepped up to say 'what do you need' and have partnered with us to get equipment and assist us in building out solutions.
Zafar Chaudry, MD. Senior Vice President, CIO of Seattle Children's: My priorities include maintaining a stable and resilient remote working platform technology, the mental health of my employees, keeping clinical services supported so they can continue to take care of patients and pivoting to virtual.
Key advice: COVID-19 is going to have a long term effect on how healthcare organizations look at their costs, how they shift delivery of care away from medical centers and how they pivot to virtual moving forward. Healthcare systems must re-evaluate all aspects of how they deliver care and make sustainable plans to put cost improvement programs into place throughout all clinical and non-clinical areas. Healthcare systems should plan to reduce back office costs, including IT, human resources and revenue cycle also.
Tom Barnett. CIO of University of Rochester (N.Y.) Medical Center: Our top priorities tended to shift very quickly once COVID-19 takes center stage. As a result, the team shifted priorities to those that immediately supported URMC, including scaling up our ability to support work from home scenarios, expanding our telemedicine care offerings to keep our providers connected with their patients, and focusing on our expenses, both operating and capital, to assist the organization through this challenging time. I am extremely proud to have a great IT leadership team that is staying synchronized with our operational leadership, and our entire IT team is doing a phenomenal job, sometimes working seven days per week, to support our front-line clinical personnel during these rapidly unfolding events.
Key advice: The game board can change so often right now as we pivot to support the next priority. Not only for us, but anyone in healthcare IT, we always want to make sure that we are supporting new workflow arrangements, including work from home, video-conferencing, telephones, etc., and are able to turn configuration changes around quickly in our EMR — be it the need for new bed types, new visit types, or new locations altogether that are needed for front-line care providers.
While all of this focus is taking priority, and rightly so, making sure that we remain vigilant on our security fronts. Hackers never take time off, and they always look for scenarios to exploit for maximum benefit when our collective industry and national attentions are suddenly drawn elsewhere. Hackers never sleep.