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Health IT Leaders Talk Pandemic Pivots, Progress and Best Practices

Organizations offer reflections on their reactionary efforts and forward-looking projects as the pandemic continues.

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Brian Eastwood is a freelance writer with more than 15 years of experience covering healthcare IT, healthcare delivery, enterprise IT, consumer technology, IT leadership and higher education.

In the earliest days of COVID-19, healthcare’s response involved rapid and unprecedented change, from the wide adoption of telehealth to the creation — almost overnight — of new units for triage and intensive care.

Now, more than six months after the World Health Organization declared a pandemic, health systems are taking stock to assess what has worked, what can be improved and what is likely to remain in place.

“There was this cultural set of beliefs to the way we work and provide care,” says Amelia Marley, vice president and chief information and analytics officer for Bassett Healthcare Network in upstate New York. “All the old assumptions are gone and had to be replaced with brand-new thinking.”

HealthTech recently spoke about the ongoing shifts with Marley and two other leaders in health IT and security strategy: Steven Godbold, vice president of operations and COO at East Tennessee Children’s Hospital, and Mitchell Parker, executive director of information security and compliance at Indiana University Health.

HEALTHTECH: What technology was most critical in supporting care at the start of COVID-19?

GODBOLD: We had to quickly figure out how to create a virtual platform for patients so we could operate as close to normal as we could. We used the encrypted version of Zoom, which was quickly scaled to what we needed; we got it into almost all of our clinics within two weeks. From July 2019 to February 2020, we averaged less than 40 virtual visits per month. From March to July, we averaged 1,600.

MARLEY: In a matter of days, we pulled our IT and systems engineering teams together to get software and equipment in the hands of the workforce where they lived or in another Bassett facility. We had to be open-minded about what devices staff were able to use to access our internal systems, which required a lot of security vetting. We also pushed to get broadband into people’s homes where necessary. Our electricity cooperatives were a helpful partner.

PARKER: Collaboration suites were very important to get disparate people across a large enterprise working together, and we were able to spin up rooms in Microsoft Teams and enable document sharing. Plus, with the relaxation of regulations for telehealth environments, our collaboration tool could be used for telemedicine.

HEALTHTECH: What initiatives have you taken on since?

GODBOLD: We moved forward with a touchless registration process. We rolled it out in the emergency room and will be rolling it out in urgent care. We also created a telecommunications system for consults between subspecialists outside a patient’s room and providers in the room.

MARLEY: We worked to provide patients access to virtual visits without having to install software; they can just click a link in their email. Zoom and WebRTC sessions are offered as alternatives for patients who don’t have Epic’s MyChart. Within the hospital, we worked with operations and facilities to extend our ICU — which New York state required by law — by installing negative pressure systems outside patients’ rooms. We also extended the use of telehealth to help hospitalists and ICU physicians collaborate.

Most of our IT workforce is still remote, and we see that persisting. We’re more engaged, productive and satisfied working this way.”

Amelia Marley Network Vice President and Chief Information and Analytics Officer, Bassett Healthcare Network

PARKER: One was a streamlined provisioning process to ensure people got the access they needed very quickly. The other was the rapid deployment of mobile devices, which enabled clinical staff to better communicate with other caregivers and loved ones.

HEALTHTECH: How have the roles of your IT teams changed?

GODBOLD: East Tennessee Children’s Hospital never had a large COVID-19 outbreak — schools were on spring break in March and didn’t return to in-person learning. We shifted the schedule of IT staff to be one week onsite and one week at home. All prior IT projects ceased and everything became related to COVID-19 response.

MARLEY: Before COVID-19 hit, we had 150 people coming into the office every day. Most of our IT workforce is still remote, and we see that persisting. We’re more engaged, productive and satisfied working this way. The ability to share materials on the screen and get feedback in real time has been helpful. Scheduling meetings is simpler now and commutes are shorter. We’re pushing new features out faster.

PARKER: The security team shifted to support the incident command structure that was focusing on the big event: COVID-19. We became a more proactive business partner, putting boots on the ground with the rest of the team to deliver a good, safe product quickly.

HEALTHTECH: How is technology supporting a transition toward reopening?

GODBOLD: Our PPE and testing supplies have been hit or miss, so we have been working with the University of South Florida on a design for 3D-printed swabs, not just for COVID-19 but for flu season. We’re also using UV lights and nano mist sprayers to clean patient rooms — the mist kills anything that has been resting on the surface.

MARLEY: A high level of communication with all staff members was important to keep people in the mindset that we were working as a team and we would get through it, especially when uncertainty was high. Our teams were leveraging tools like Jabber and TigerText for messaging and Zoom for town hall meetings.

Our practitioners see patients with special needs in a new light when they have virtual visits in their homes, which has helped in care planning.”

Steven Godbold Vice President of Operations and COO, East Tennessee Children’s Hospital

PARKER: We used a lot of existing collaboration tools. You can’t restructure and reopen unless you have a good project plan, and you need to coordinate with people across the state to make that happen. We also set up virtual screenings for patients to use prior to coming to the hospital, and we made sure to communicate with our community and set good expectations for what reopening would look like.

HEALTHTECH: What unexpected advances have come from your COVID-19 response?

GODBOLD: We’ve seen that pediatric psychology patients are more likely to share information in their homes than the office environment. Our practitioners see patients with special needs in a new light when they have virtual visits in their homes, which has helped in care planning.

MARLEY: As we have learned how we have to think differently, we’re now making sure that technology is part of the conversation. It hasn’t always been that way, but for the modern healthcare organization, technology needs to be understood as a strategic differentiator. It’s not data processing in the basement anymore. We need to appeal to consumers’ requirements for where and when they want care.

PARKER: We need to emphasize mobile as a delivery mechanism, not just for telehealth but for other services. You’re not able to deploy a brand-new physician’s office in a day, but if we support mobile technology, we can get physicians onboarded and deployed quickly, and get a professional in front of a patient as quickly as possible.

DISCOVER: How will healthcare facilities change during and after the pandemic?

HEALTHTECH: How has the pandemic reshaped your organization’s technology vision?

GODBOLD: Our strategic plan for virtual care had been rolling slowly for two years, because providers were reluctant to adopt. With COVID-19, everybody jumped on board, and now we’re trying to get our infrastructure caught up. We’re also working to build an all-encompassing tele-triage app that integrates with our EMR; we’d been talking about it for three years, but now it’s back to the forefront.

MARLEY: We’re thinking about how to start the patient experience long before they get to the hospital or the clinic. Epic has some e-registration features that can get the administrative questions out of the way before they get to the door. There are a lot of platforms that text patients and send other reminders.

PARKER: Telehealth and remote monitoring are quick wins, but we’re also planning for a distributed workforce: Do you really want to have all your employees in the same building where you’re taking care of patients? It’s about asking what your workforce will look like and how you can deliver services to them.

Otto Steininger/Ikon Images