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March 26, 2020: San Banerjee from Texas Health Resources joins us on the show today to share his expertise on telehealth and to continue our series on COVID-19. He unpacks how systems can easily get started on the telehealth project if not already up to speed by using easy apps and resources such as Skype and FaceTime. His recommendation is to connect these different platforms in order to cover all the bases needed for an effective telehealth service. San explains how Texas Health Resources has laid out their system, using Microsoft Teams as the centerpiece. We also get into just how quickly these advancements have been engaged with and adopted by health professionals whose institutions were maybe not quite up to speed before the corona crisis. In addition, the conversation covers some of the challenges that can arise trying to stand new operations during a crisis and our guest shares some information about a helpful app that he and the organization adapted to address these. Listeners will also hear about the idea of the democratization of EHR and what is going on on the ground in Dallas at present. Make sure to listen in as we show you just how possible it is to get up to date with telehealth!

Key Points From This Episode:

  • Making a start on telemedicine; using simple tech to get connected. 
  • Employing a combination of services to build out a telehealth system. 
  • Microsoft Teams' utility in tying the different pieces of telehealth tech together.
  • The response from doctors to the imperative for telehealth; enthusiasm and progression.
  • Arising challenges in the crisis and the healthcare app that San and his team have launched. 
  • Maintaining a single point of truth during the crisis; the democratization of EHR. 
  • An update on the current situation in Dallas; patient numbers and more. 
Transcript

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

 Welcome to this Week in Health it. With our continuing series on Coronavirus Prep, we've moved from understanding the health IT problems to start looking at the solutions around these problems. My name is Bill Russell Healthcare, CIO, coach and creator of this week in Health. It a set of podcast videos and collaboration events dedicated to developing the next generation of health leaders.

Before we get going, I wanna make you aware of three resources for those in Health IT during the Crisis. The first is for CIOs. I'm currently helping my coaching clients as a sounding board and advisor through this time. If you'd like to connect with me over the next couple of months to experience coaching at no cost, shoot me a note at bill@healthlyrics.com.

For anyone in health IT who finds themselves in uncharted territory and wants to crowdsource solutions with a team of seasoned professionals, we have set up two ways that you can do that. Uh, the first is a Slack channel, and the Slack channel is monitored and supported by our sponsors, VMware, Giln Healthcare, serious Healthcare, Starbridge Advisors, pro Talent Advisors, and myself, health lyrics.

The Slack channel allows you to get your questions answered around Telehealth, VDI, you name it. Uh, there's great resources in there. There's technologists, there's CMIOs, there's CIOs, uh, just great resources. If you want access to the channel, send me a note at Slack at this week in health it.com. That's Slack, exactly how it sounds.

S-L-A-C-K at this week, health it.com, and we will get you set up immediately. Our sponsors are also supporting an email channel at support at this week in health it.com. If you just wanna shoot me an email over, I'll get you routed to the expert in the area that your question pertains to from our group of sponsors.

Um, I really appreciate our sponsors stepping up to provide these services to our listeners and to the industry. Now to our guest, Sam Banerjee is the VP of Digital Experience for Texas Health Resources, and I'm excited to have him on the show. We're gonna talk telehealth. Uh, specifically and how, uh, health systems are piecing these things together.

Incredibly creative, incredibly resourceful. I look forward to, uh, this conversation with sand now to our guest for today. Sand Banerjee is the VP of Digital Experience for Texas Health Resources. Uh, good afternoon, sand. And uh, welcome back to the show. Former, uh, guest of the show. Happy to be here. Yeah, I'm, I'm excited to talk about you.

I saw a LinkedIn post that you put out there, and I was really intrigued. It said, you know, it just, I'll just read it. If you're seeking advice, recommendation on how to implement telemedicine in your health system or regional health centers, uh, to respond to Covid 19, please contact me and would be happy to help.

And, uh, here's what we're finding. People are scaling these things up. And, uh, there's all sorts of need and, and you know, telehealth is really seeing a boom right now. Uh, but a lot of people, I'm on our Slack channel and other things where people are asking questions, they're trying to figure it out because there's a lot of, there's a lot of challenges.

So what kind of, what kind of things are you seeing and then what kind of things are you. Kind of, you know, advice are you giving people as they implement this? So I think these are very uncertain times, bill, um, and telemedicine used to be an and in many things for, from providing care. But the way I'm seeing this is primarily in the critical path in terms of how we can give and distribute care.

Uh, ensuring that we can do virtual care, keep our providers safe, and also ensure that we can do it in a very quick and fast way. So my, when I put the post in LinkedIn, I think my, uh, whole, uh, whole aspect was, you know, all health systems have different technologies in place today, right? And how do we bring all those technologies that we have to really provide telemedicine?

I'll give you some examples. Many health systems have Skype, for example, that they use for collaboration tool within the system. Skype can be used for telemedicine. And, um, I can, I can help setting up Skype to ensure that, you know, you can see your patients using Skype. It may not be an integrated experience, but it'll be a good place to start.

Similarly, there is FaceTime, uh, on the, on the phone. Now the new regulations that CMS has declared, uh, two weeks back, helps all the providers to really be on the phone, be on Skype, and, uh, be doing the telemedicine the way it has never been thought, thought or done so far. Yeah. So, so we break these things down.

Uh, telemedicine platform has a handful of things. One is, it has a queuing system. So Queues up has an education platform. So while you're waiting, they. You know, streaming videos or, or those kinds of things. Uh, some of 'em have an input mechanism where you're actually typing in some things before you actually see the physician.

Then you have the tele, the, the teleconference technology, and then generally you have a documentation platform. And I, I think what people don't recognize, and a lot of these telehealth platforms, the, the documentation platform isn't the EHR, it's the telehealth platform. And, uh, and it's, so anyway, so we're gonna break these things down and I, I just, I, I wanna walk through with you.

So if I start using Skype or I start using, um, FaceTime, those are great, but those are. They're designed to be one-to-one kind of things, and there is no queuing mechanism. So how are you going to set up those calls? Are you initiating outbound calls to patients? So I, I'll kind of walk you through a couple of scenarios here, right?

So just looking at Skype, right? Skype is a technology to use to do teleconferencing, but you can put Microsoft Teams to do queing. Okay, so anybody has, having a Microsoft, Microsoft ecosystem can use Microsoft Teams for doing queuing and then use Skype to do the teleconferencing or whatever the conferencing that is needed, and then keep the EHR to do documentation.

So in this whole process, the three pieces together and those three pieces could be stand up in a week, less than a week. Um, and teams is already available and people can use that for collaboration that is needed. Yeah. So that's, uh, so that's fascinating. So you bring teams into, so the EHR should be the documentation platform.

They're gonna do that. And that makes, I think, that makes sense to a lot of people. Um, talk to me about the, the teams as a, uh, queuing platform. So, you know, what are you giving your patient community to say, hey, or, I mean, so here's what's happening. A lot of our primary care physicians, their offices are empty.

And they're empty 'cause people are afraid to go to the offices, but they still wanna see patients. They still need to see patients. So we're standing them up with telehealth very rapidly. Um, how do we stand up teams as the front end system and, and what do we give the community to, to get in line to see that doctor?

So I think the teams, the way it works is the teams is given for providers. So providers will have the team access, right? Anybody having a, an Outlook account or whatever the account looks like. So they can be set up on the teams. The patient typically gets an uh, request or they can initiate a request from their perspective.

All it does it, it kind of comes and adds to the team, queue for the provider. If the providers are all tied together, right, and on teams now, the provider can initiate a call and the Skype call can be connected to teams. So the Skype, and because Skype is part of the Microsoft ecosystem, it is all connected with teams.

You, nobody has to do anything separate to start a Skype call, right? Because it's connected. So the patient can initiate that and it comes to a provider queue, and then provider picks it up and uses Skype to do the call. The other part of this is that we can use quick technologies, like if, if somebody has a Salesforce, if some enterprise have Salesforce, Salesforce has texting mechanism that can be put on people's phones.

So you can use Salesforce for queuing when somebody comes into the text channel. And that can be given to the providers as a small app. And Salesforce has this texting app that can be used for queuing. So what the provider is doing is, provider has the Salesforce mobile app on on the phone, which is used to really see who is coming through, and then use the EHR for documentation and use any other, uh, video conferencing, do the conferencing, like a FaceTime.

You know, this is fantastic. I mean, what are you finding the response being from doctors. So some of these, uh, a lot of doctors have used, uh, televisits to be fair. Uh, but it, it didn't have wide adoption. I mean, if we're just honest, I mean, we were, we were just ticking, ticking above, uh, you know, nominal numbers.

And then all of a sudden now , it's our, our numbers are, are through the roof. Uh, how are, how are doctors feeling about it? How are they responding to it? How are we getting 'em, enough training? And those. So I think the, the way I'll say this is the need has brought us all together. Yeah. So people are doing extra hours to train themselves.

Even if I send a document to them, they just look at the document and say, Sam, I'm ready in. Just to give you some perspective, in last one week, I have onboarded 970 physicians on telemedicine. Wow. Nine 70. Yeah. That's, that's amazing. What, uh, I mean we're, we're not pushing any technology, but what was your platform before this?

I'm sure it was a well thought out telehealth solution. It wasn't what you're doing now, but what was your primary telehealth solutions? It was Amwell that we started off with. Yeah. Um, so I started off with Amwell and now because we have to scale up so much, first of all, Amwell is basically, we are using it for primary care, but within the hospitals we are using Microsoft teams.

We are using Skype and other technologies that we can bring together. So we have brought all these things together in the hospital pretty quickly. And Amwell, we are, you know, we have ramped up 970 primary care providers in seven days. Yeah. And this is a, this is the exciting thing about this time is you got, uh, health, it is really shining at this point.

You guys are MacGyver. You're sitting there going, all right, what, what do we got here? We, we've got this, we've got this, and you're pulling it together. Are there other areas where you guys are sort of stepping in and trying to, uh, help with solutions to, you know, challenges that are, I, I'm sure there's just challenges popping up all over the place.

Yeah, so one of the things that we are doing is we have stood up a texting app for Covid Ovid 19. Uh, specifically this is ASMS text-based, uh, app, which is called Hospital to Home. So anybody can download that. And if you're part of our patient list, you'll get access to that free, uh, for whatever time it is needed.

And once you start texting, you will basically have a response from an emergency physician within 30 seconds. Wow. Okay. So this helps on the access part of this to really route the right patients in the right place.

Not answer the, the texting, uh, application. Was this something you already had in place or something you guys had to go out and, and, uh, and, and source once this came up? So we already had a texting app that we had, we had, uh, developed for hospital to home people who were coming out of our, our emergency room and giving support for seven days.

We rebranded that completely to support Covid 19. Yeah, that's interesting. In, in three days, , um, are, so what are you doing for your single point of truth? So one of the things that's important in the health system is that everybody has access to the same, well, similar information, if not the same information.

So everybody's up to speed on, on what's going on in the community, in your hospital. Um, things like, uh, uh, you know, inventory, uh, on, you know, you name it, there's a lot of inventory issues that we're looking at, uh, time for tests to be done. How are you, what, how, how are you, what technologies or, or what mechanism are using to keep everybody informed?

I think we use something called Community Plus in Salesforce because we are a Salesforce shop and what we are doing is we are trying to bring the community Plus up and get all the feeds that we need from the community into one place. So that we can got all that informed. That has really helped us and it was given by Salesforce pretty much, you know, to us.

We of course, to ensure that we can handle the situation better. Also, the way we are doing a democratizing access to EHR, which is EPIC for us, said that we have told providers you can go and do your documentation, and as long as the documentation is in some format, we'll pull it into ehr and there's a team to do all that today.

So that we don't have to bog them down in terms of doing documentation in the right format. Yeah. And you know, just, just to close out, because we're trying to keep these conversations pretty. Tight. 'cause we know that people don't have a lot of time and we want to give them access to things. Uh, you know what, what, what do you, um, what's, you're in the Dallas marketplace, well actually you're in a bunch of marketplaces, but Dallas being home for you guys, uh, what, what, what are you guys experiencing right now and, uh, where are you at?

So, we are at Tuesday. Uh, the, uh, is it Tuesday? No, it's Wednesday. Isn't it Wednesday? Yes. Wednesday days. Days are meshing together here, but so it's the 25th on, uh, Wednesday. Uh, you know, what's the situation like in Dallas at this point? So we have, um, we have been, we have rep, we have reported and they have reported saying 5,000 patients have been tested.

Um, kind of person of interest, uh, positive. And we are seeing the influx into our hospitals and phone calls in terms of our contact center, our help center. Um, so we saw about 800 patients in last two days. Um, people who are of interest and are somebody who has tested positive and that that number continues to grow.

Yeah. But you're at the front end, so this is a very manageable number at this point. That's right. Um, yeah, so, well, you know, that's, I mean, thanks. I mean, I really appreciate you coming on the show. I appreciate you breaking the, uh, telehealth thing down. Um, I, I, I think it's important to understand, you know, in most cases if we didn't have everything buttoned up and we went to the physician community and said, Hey, here's our telehealth solution.

They've looked us and said, go back and keep working on it in today. You know, necessity is the mother of invention, and they are, uh, what I'm, what I'm hearing from the field is physicians are extremely happy to adopt, uh, you know, really well thought out solutions, but maybe not all tightly integrated like we normally would deliver to them.

Right? I think the word I'm going to use, uh, bill, is let perfection not be your enemy at this point. And telemedicine is a game changer. It is needed at this point to really help and distribute the care that we need, and I stand it to really help whatever is needed. If any health system, regional health centers, were looking for help, I'm able to help to really kind of get to the situation here.

Um, and I know some of those things can be pulled together to really help. So my appeal is, you know, do not be shy. It is not to be perfect. You know, get whatever you have to really help your communities. Sounds good. Well thanks San. Is there any way people can get in touch with you? Yeah, so I am on LinkedIn, um, and um, my LinkedIn profile is San Banerjee.

Um, if you just look it up. And then my email address is sand banerjee at outlook com. Fantastic. Hey, thanks again for, uh, taking the time. I really appreciate it and uh, we look forward to catching up with you, uh, after this to see how much of this stuff becomes a part of the normal operating procedure.

It'll be interesting. Absolutely, bill, and always good to talk to you. Thanks. Take care. That's all for this episode. Special thanks to our sponsors, VMware Starbridge advisors, Galen Healthcare health lyrics and pro talent advisors for choosing to invest in developing the next generation of health leaders.

This show is a production of this week in Health It. For more great content, check out the website this week, health.com or the YouTube channel as well If you wanna support the show, best way to do that is share it with the peer, however you do that. Uh, we're gonna be back again tomorrow and the next day, uh, we're gonna keep dropping episodes with, uh, around solutions and with, uh, influencers who are gonna help us to provide meaning around the different things that are happening during the, uh, pandemic that is going on.

Thanks for listening. That's all for now.

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