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How did your health system make it through the pandemic and what's next?

Great topic for a panel discussion.

Moderator - Tanya Townsend - CIO Louisiana Children's Medical Center

Angela Diop CIO, Unity Health Care - FQHC

Aaron Miri - CIO, Dell Medical School & UT Health Austin

Richard Corbridge - CIO Boots IT UK

"it was really a lot of effort for us to maintain some of these on-prem systems and servers. And so making that decision and moving that infrastructure to the cloud was incredible and pretty much in the nick of time because of the pandemic. We really were able to maintain uptime and availability and, and scale" Angela Diop

"Trust is built from transparency" Aaron Miri

"The easiest way to get consent for sharing data (beyond it's original purpose of primary care) is to simply ask for consent. And we appear to not be doing that." Richard Corbridge 

Clearly they said a lot of other great things, but these posts have a character limit. Check out my retrospective on this and several other keynotes from the @CHIME summer forum.

#healthcare #healthIT #cio #cmio #ciso #CHIME #HIMSS

Transcript

This transcription is provided by artificial intelligence. We believe in technology but understand that even the most intelligent robots can sometimes get speech recognition wrong.

  Today in Health it, this story is chime recap. Today we're gonna look at one of the first panel discussions that they had, one of the keynotes. And we're gonna go through that great panel discussion and I think we have a lot to get out of it. My name is Bill Russell. I'm a former CIO for a 16 hospital system and creator of this week in Health IT a channel dedicated to keeping Health IT staff current and engaged.

VMware is our sponsor for today. They've been committed to our mission of providing relevant content to health professionals since the start, and they recently completed an executive study with MIT on the top Healthcare Trends, shaping it, resilience. Covering how the pandemic drove unique transformation in healthcare.

This is just one of many resources they have for healthcare professionals. For this and several other great content pieces, check out vmware.com/go/healthcare. All right, today, first panel discussion. We're probably gonna do a couple of these this week. Just go through some of the things that I took away from the Chime conference last week.

First panel discussion is Tanya Townsend. C-I-O-S-V-P at Louisiana Children's Medical Center. She was the, uh, moderator she had. Richard Corbridge, CIO, boots, UK Alliance, Angela Diop, DIOP, Diop, CIO, VP Information Systems, unity Health, which is a federally qualified healthcare clinic. And Erin, Mary. Former guest of the show, CIO, Dell Medical School, UT Health Austin, and, and one of the first things to note here is really interesting cross section, right?

So you have a federally qualified health center, you have an academic medical center, and you have the boots. Really a retail pharmacy type operation in the uk. All right? So very different geographies, very different service lines, very different budgets, you name it across the board. So they kicked this off and they asked the question of early on in the pandemic, what are some of the things you did and how'd you scale those things?

And you get a, a really good cross-section right there out of the gate. Richard is from the Boots Alliance outta the uk and he said one of the things that they were focused on. And the lockdown was how can we get people access to a general practitioner, to a gp and virtually in two and a half thousand boot stores across the country, they went to a telehealth type model.

They had trouble really getting people the care they needed during the pandemic. There was just a, uh, significant amount of demand that really taxed the system. Then you had Angela share that one of the things they were really thankful for that they got done was they had moved to the cloud. And here's a quote.

You know, it was really a lot of effort for us to maintain some of those on-prem systems and servers. And so making that decision and moving that infrastructure to the cloud was incredible. And then also, we did it pretty much in the nick of time because of the pandemic. We were really able to maintain that system, that uptime and availability and to scale that.

Along with the pandemic. It's interesting when you look at, and, and then Aaron goes on, Aaron Mary from Dell says their, their biggest challenge was making sure that the analytics, from an analytics perspective, they were getting the data in the right place at the right time for the clinicians to act immediately.

I. And you almost see the the levels, right? Federally Qualified Health clinic is just about maintaining the systems during a pandemic and then building off of that and incrementally building off of that. Aaron's dealing with a higher level set of problems, right? So they probably have cloud systems, they have pretty.

Sizable budgets and they're able to stand a lot of these things up. This is gonna be, if you're haven't figured this out already, this is gonna be part of my, so what is, how do you go to these conferences and how do you determine what things you take away from this and apply to your health system?

They're all dealing with very different things. If you just listen to this, I. Just generally, you're, you're gonna say we're not up to the standards of the Dell Medical School, and very few are, quite frankly, across the country, very few health systems are, or have the budgets to, or have the access to academic resources that they do.

I'm, I'm actually going to my so what now? And so you have to be careful what you take away from these things and what you say, what's the next thing for our health system? Alright. She, so Tanya goes on and says, Hey, how do you handle de-identified data moving forward? So Aaron offers some great advice here and he talks about wrapping it in governance and you have to be able to do an audit, understand where your data is and where it's going, and who it's getting to.

So you ha it has to have an audit trail associated with it. I thought one of the more interesting answers to this question about de-identifying data. Was Richard Corbridge and he says We appear to be making the same mistake and remaking the mistake we've made in the past around how we communicate consent, and this idea of consent is coming up over and over again.

I have another conversation coming up on this week in health it where I talk consent with one of our guests and how we communicate it, how data can be used for clinical research above what it's originally been collected for, for primary care and for general services. And so Richard again from the UK says The easiest way to get consent for sharing data is simply to ask for consent, and we appear to not be doing that.

And I don't think that's only a UK problem. I think that's a problem in the US and that's going to come back and bite us if we don't get ahead of this. Tanya turns the conversation to cybersecurity. We spent a lot of time on cybersecurity last week. And they offer some interesting insights as, as is always the case with Aaron.

He has a three step approach. Number one, audit your organization. Make sure you know where your data is. We've already talked about that. And then he gives a great quote, which is trust is built from transparency, and I'm gonna use that over and over again. So you have to have an auditable practice. Number two, he says, manage third party risk.

Again, a good model, understand where your data is, manage third party risk, and then he goes on to talk about, make sure that third thing you get to precision data, start really tracking where the EPHI is going and who has it and, and what they're doing with it. Again, good three step model there. Tanya again, turns the conversation to talk about at-home care models.

Angela shares some interesting thing. Again, federally qualified health clinic. One of the things that opened this up was the funding that came out of the national emergency for Telehealth, which really opened up their progress. And she talks about the fact that they went from zero telehealth visits to almost a thousand a day, which is a huge deal.

And since the peak of the pandemic, they've only dropped that to about 50%. And even though there are some challenges in her community, and she talks about some of those, she talks about access to broadband and other things. She talks about how that has really. Given them the ability to see these patients more often and provide a higher level of care.

So, very interesting. And again, so that's where they're at. It's went from zero to a thousand a day. The, uh, uptake on that is significant. The growth on that is significant. The change in that organization is significant. These are dramatic changes, whereas someone like a, a, UT Health or Dell Medical School, telehealth was already there, so they're already using it.

And it expanded, but it wasn't as dramatic of a change in the operation of the organization. So he, again, he's dealing with a little higher level problems, and so he talks about the challenges they're dealing with is how to measure the effectiveness. Care at home and the, the quality of the care at home and the quality of the telehealth visits.

And then the second thing is how do they bring that integrated practice model to the virtual world, to the telehealth world? And again, different level of how they're looking at it. One is, Hey, we're gonna provide this. And the second is, Hey, we've been providing this for years. Now it's expanded pretty significantly.

We need to figure out models that . Look like what we're doing within the four walls of the hospital and extend those out to the home and see is this effective? Are we doing this well? How do we make this better? So it's incremental, making it better Along the way they talk about payment models and in the uk completely different challenge than we were facing in the us.

And he talks about the pandemic, pushed them into 1980 styles waiting lists to see a general practitioner, and telehealth somewhat rose to meet that challenge, but then backed off very quickly. They weren't able to make the moves that we did in the US quite as quickly. Angela again talked about the broadband challenges and also the physician burden.

If you're going from zero telehealth visits to a thousand a day, you implemented a lot of things very quickly. And maybe didn't bake in the processes as well to handle the, uh, physician burden. And you may not have the budget, quite frankly, that other organizations have to create a, uh, a dedicated virtual environment.

So Angela talks about some of those things I. and Richard goes on to talk about how Telehealth allowed them to have really a supply chain of care, allowed everyone to practice at the top of their license, and that is one of the, one of the benefits of the agility of telehealth. They talked about the change in governance models coming out.

This is actually a question from the audience. I enjoyed this question because it gave Aaron an opportunity to share some stuff, which I thought was really excellent and he said we were asked to move quickly. Speed was of the nce. But the priorities really went by the wayside. The priorities really got focused into a handful of things around the pandemic.

And what he said is they're going back as quickly as possible to their normal process 'cause it's more aligned, right? So they align their top projects to budget because money changes the conversation. They align their top projects to mission because mission is so important to make sure that you're heading in the right direction.

And, and some of this wasn't done during the pandemic and we did everything as quickly as possible to meet the immediate need. And you put those things on the back burner, but we have to get back to them very quickly. And the last thing that he gave us around this was to communicate with the executive team, often around not only the projects and the cost, but the advancement of the mission and the objectives of the organization.

And that is phenomenal advice. Uh, again, another question from the audience was spout, what tools are you gonna carry forward or what tools are you looking at moving forward? And again, Angela, federally Qualified Health Clinic, EHR, they're . Is this the EHR to carry us into the future? It's a great question.

But then you have the academic medical center, which is, they're looking at automation and digital tool development, DevOps, and those kind of things. And it just shows you the difference, right? Very different priorities based on where they're at, where the budgets have been over the last decade or two decades in the funding and what, what the priorities are moving forward in terms of partnerships and those kind of things, even in the conversation.

Aaron Mary, uh, quotes Russ Brazel talking about CIO 2.0 and maintaining the EHR and CIO 3.0. And the digital tooling of healthcare, which I think we've all heard Russ give some version of that. But the reality is some health systems aren't ready for a CIO 3.0. If you, if you took a CIO 3.0 and dropped them into a federally qualified health clinic, they would immediately go back on Maslow's hierarchy.

To the immediate needs of the health system, which is to optimize that EHR and to put a set of tools in place that optimizes the delivery of care to that community. Different communities, different budgets, different approaches are required. Being an excellent CIO 2.0 is as important as becoming a CIO 3.0 if you are running an academic medical center or a large IDN.

Alright, so that's about enough for that, that talk. I wanted to give you guys an, an idea if you didn't get a chance to. Uh, hear that talk and I'm gonna do a couple of the others 'cause they had some really great panels at Chime for their summer forum. So great insights. I would say to leaders out there, understand where your health system's at.

I've said this two different ways already. I'm gonna say it one last time. I. Understand where your health system's at on the maturity matrix, and take advice and examples and adapt them to where you live. While Aaron's examples are fantastic and they are, that's why we have 'em as a guest, often you may not have the resources, both in access to academic medical center resources or the money that comes along with it.

Don't put that on yourself. Identify the things that you can bring to your organization. Don't use what I'm saying as a free pass either. Better. Is the goal better tomorrow than you are today? Repeat that every day, this year, and you will make progress. If you prioritize well, you're gonna make progress in the right areas, moving the entire organization along, but don't saddle yourself with the guilt of trying to get somewhere that you just can't get to.

All right? That's all for today. Don't forget to check back. We'll do a few more of these this week, looking at the keynotes from Chime Summer Forums. If you have someone that might benefit from our channel, please forward them a note. They can subscribe on our website this week, health.com, or wherever you listen to podcasts.

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