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April 27, 2020: For today’s field report we are joined by Patrick Anderson, CIO at City of Hope in Los Angeles. We dive right in and hear about the IT systems that Patrick and his teams are building out at a rapid pace at City of Hope to cope with the pandemic. Patrick tells us about a system for checking the temperature of visitors to the hospital en masse using a flare camera system, and a drive-through COVID testing facility with preregistration on Epic too. We hear about the challenge of shutting down the extensive research facilities at City of Hope, and the benefits that prior remote work arrangements are having in getting teams and researchers set up for Televisits as well as work from home capabilities. Patrick talks about the rapid speed this has all happened in at the cost of long work hours, and which organizations his teams have partnered with to make it all happen. We also find out about all of the IT upgrades that have been placed on hold at City of Hope to make way for ones relevant to the crisis and which of the new remote systems will stay or go once we reach a new normal. Tune in for more.

Key Points From This Episode:

  • IT systems built out at City of Hope since the start of the pandemic.
  • Solving the problem of temperature checking visitors using flare cameras.
  • Building a drive through COVID testing capability with preregistration on Epic. 
  • How the teams rapidly scaled Televisits and work from home capabilities.
  • The challenge of shutting down the extensive research facilities at COH.
  • Running seven days a week, 12 hours a day for 30 days to shut the facilities down.
  • Work from home research facilities and having researchers who were already mobile.
  • Scaling into telehealth with AmWell from a previous focus.
  • Future plans to integrate the AmWell telehealth system with Epic charts.
  • The value of taking time to scale telehealth despite being able to do it quickly.
  • All the platform-based upgrades that are on ice now while the focus is on COVID.
  • Which of the recent changes will remain once we hit a new normal.
Transcript

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 Welcome to this week in Health IT News, where we take a look at the news which will impact health it. This is another field report where we talk with leaders from health systems and organizations on the front lines. My name is Bill Russell Healthcare, CIO, coach and creator of this week in Health. It a set up podcasts, videos, and collaboration events dedicated to developing the next generation of health leaders.

Are you ready for this? We're going to do something a little different for our Tuesday Newsday show. Next week we're gonna go live at noon Eastern 9:00 AM Pacific. We will be live on our YouTube channel with myself, Drexel Ford Sus Shade. And David Munch with Starbridge Advisors to discuss the new normal for health.

It, uh, with you supplying the questions with live chat. Also, you can send in your questions ahead of time at hello at this week in health it.com. Uh, I'm so excited to do this and I hope you'll join us. Mark your calendar. Noon Eastern 9:00 AM Pacific on April 28th. If you want to, uh, send the questions, feel free to do that.

Um, and uh, you can get to the show by going to this week, health.com/live. This episode and every episode since we started the Covid 19 series has been sponsored by Sirius Healthcare. Uh, they reached out to me to see how we might partner during this time, and that is how we've been able to support producing daily shows.

Special thanks to Sirius for supporting the show's efforts during the crisis now onto today's show. Today's conversation is with Patrick Anderson, CIO, at City of Hope in Los Angeles. Good morning, Patrick, and welcome to the show. Good morning, bill. Glad to be here. Is is City of Hope, uh, is it specifically in LA or it's, it's on the outskirts of la right.

Yes, we're on the east side of Los Angeles in a town called Duarte, and then we also have a big administrative campus in, uh, in, in a, in a nearby city next to Duarte on the other side of the freeway. But we have two, two campuses basically. And then we're building out a, uh, a campus in, uh, in Irvine, in Orange County.

Uh, looking forward to, to that being built out. Although I'm not in Orange County anymore, I'm in, I.

Uh, cancer treatment in, uh, in, in that market. So it's, it's exciting to see that, that project moving forward. Um, great. Let's, uh, so the thing I love in talking with you is that we get very pragmatic very quickly, and what I wanted to do is just hear about some of the things that you and your team at City of Hope have been, uh, have been doing, have stood up since the start of the, uh, pandemic.

Basically one emergency project after another for, uh, for it to jump in and, uh, and assist with, uh, with all of the covid planning and all the operations work. Primarily our, some of our initial work bill was around. How are we going to assess the temperature of all of the, uh, employees and the patients that are coming in and the visitors to try to identify potential, uh, symptomatic covid patients?

We tried to use handheld, uh, temperature monitoring tools, and they were breaking down. They're just not designed for. We did an evaluation with, uh, FLIR cameras and they, they looked very, uh, they looked very interesting and we were able to create a workflow at six different entrances into our ambulatory clinics and our hospital to, uh, to monitor everybody that's coming in.

And we were able to identify any patients over with over a hundred degrees Fahrenheit temperature. And then we were able to isolate them and, uh, and, and work with them to determine, uh, you know, the appropriate next steps. So that was a, that was a big deal, and getting those, um, that, that's, that, that's really interesting.

So help me to understand that a little bit more. So the, the FLIR cameras are like mounted on the wall and monitoring people as they're walking through. Because state regulations, we couldn't mount anything. So we tripods and we were monitoring all of the all.

And segregate them and then do a, uh, a, a manual temperature of them, you know, under the tongue and so forth to identify, uh, potential issues. So that, that was a big success. The nurses loved it and, uh, it was terrific. Um, some of the other, uh, interesting things we were doing is we built out a. Drive through covid testing capability, um, with, uh, with preregistration and, and, uh, I think our, our quality officer said, man, this is working like butter.

They really love the workflows that we built out in Epic and the ability for us to, uh, to do the drive through covid testing and we, we actually.

Uh, connectivity out there with our, with our infrastructure group. And then our applications team, were able to make some emergency changes to Epic and, and bring that up online pretty, pretty well. So that was a, that was just a marvelous, um, work between, uh, clinical leadership, our applications group and our infrastructure.

Yeah. That's fantastic. Network done wirelessly or did have.

More permanent in place. Yeah. We created a, a wireless capability out there with some, uh, with some devices that we were, we were, we had to run power out there. But after we were able to run the power, we were able to bring up some wireless devices and connect to our, uh, our enterprise wireless, uh, infrastructure.

Did you end up having the, the medical record out there? Did you have access to the medical record or did you not need Yes. Oh, you did? Okay. Yes. Yep. Yep. Fantastic. Uh, I, I assume you know everybody, , I, I appreciate you not starting with these two things because everybody's talked about 'em, but I, I'm curious how you guys did, you know, work from home, telemedicine, uh, talk a little bit about those initiatives and,

you know. Uh, bill, we, we, uh, we literally, uh, shut down, um, dozens and dozens of buildings. You know, we have pr, uh, pretty extensive, uh, research capability at City of Hope and, uh, to, uh, to shut down or reduce laboratories across dozens, dozens of buildings and thousands of employees. It was very, very challenging.

Set up multiple. Human resources and, and all of their partners and literally go across the enterprise and prioritize who's gonna be, uh, moving off campus and how are we gonna do that with, uh, with education and guidelines and so forth. So we ran these genius bars around the clock. Dell is a strategic partner of ours and we were to obtain, um, hundreds and of laptops and we a.

Four week we moved over three people home and most of the patient, so it ran a 12 hours a day for 30 days and able to accomplish quite feat. I appreciated your email I sent you early on. Hey, hey Patrick, any chance you could go on the show? You're like, I'm a little busy right now, . I was like, yeah, I guess you were.

Uh, so, so talk about telemedicine and, uh, well, you know what's interesting about your work from home is you really moved a research facility into a work from home environment.

Some of the special, special applications.

You know, our researchers already work, uh, on an international basis Bill. They work, uh, they work around the world around the clock and they're, they're constantly on the road. You know, we're constantly supporting our research leadership and, and our researchers at, uh, at conferences and, uh, and doing collaborative work all around the world.

So they were already very mobile. It was really following research leadership and the work they wanted to do to slow down or even shut down some laboratories. Many laboratories still could not be shut down and, and obviously they're, they're also shifting a lot of work on covid research and vaccine development.

We do a lot of, um, you know, drug development.

It was literally a, a shift of priorities as well as, uh, uh, helping and ensuring that we follow the research leadership path on, on making sure everything can, can continue with a partial on campus, off campus, uh, workforce. Wow. Uh, talk a little bit about telemedicine. So I, I.

Our standard is American. Well, they're a partner with, uh, with us, and that's our telehealth telemedicine platform. We were basically doing, uh, second opinions and helping large employers with their, uh, with their patients and their families, uh, going through, uh, you know, cancer, uh. Cancer situations. We weren't really doing telehealth yet directly with our own patients and so forth.

But once this hit, and obviously we wanted to have our physicians work from home in the ambulatory space and and literally have the entire workforce trying to work from home. So we stood up. Well for, uh, for video and, um, uh, matter

visits a day on the American Well Platform. We haven't done the integration with Epic yet on the charting where a physician has.

Or two before we have that ran up. But it was really a six to nine month project that we had just, just, uh, started the conceptual work on before Covid hit. And then we did, uh, we literally did nine months of that work and stood it up in a matter of three weeks. So it was pretty, pretty phenomenal heroic work.

So do you think that's gonna be the new expectation on health it the next time we're sitting in a meeting and we're going, yeah, that looks like it's, you know, probably an 18 month project. Somebody's gonna say, okay, do it in three weeks. Gosh, I hope not Bill, because, uh, you know, we, we've been working nights and weekends to make all of these things work and it's a little, it's a little challenging.

You way, we like to do a lot more testing. We like to do a lot of test environment build and sometimes it's, it's good to aim before you shoot, right? Yeah. So, uh, so hopefully we can get, get back from a systems development perspective, get back to Norm, but I think the future is definitely gonna demand more, uh, more, more telehealth and more, uh, and, and other types of, uh, of virtual work for sure.

You know, I know you were doing a lot of platform work prior to this. I mean, your, your, your, uh, run rate stuff. You were really focusing in on platforms and modernizing the, the infrastructure and whatnot. Uh, how did, how did that, how did that play out during the, uh, during the crisis? You know, nothing delivered fast enough in our world, unfortunately, you.

Our ERP we're, uh, we're literally, uh, optimizing our epic across revenue cycle as well as clinical, all new workflows, all new capabilities, our infrastructure, everything is, uh, everything is being upgraded from data center modernization to complete infrastructure. We were just about ready to launch our voiceover ip.

And, uh, and, and roll that out to some of our new buildings. We have many, many construction projects happening right now. And, uh, and, and being able to, uh, to leverage a lot of that development work is good, but it literally had to, had to shift all of our priorities, which is very challenging. We're gonna continue our pace with, uh, with many of the large foundational infrastructure projects.

Shifting everybody to,

so.

But h how do we, how do we come down off this mountain? I mean, as you said, you know, working seven days a week, we're doing just incredible things. There's, there's a sense in which you got to the top of the mountain. We should, you know, take the group photo, pat each other on the back and say, look, we gotta the top of the mountain, but at some point we're gonna start descending back to a new normal.

How do you, how do you do that effectively? I have to tell you, bill, I think that, uh, work is gonna be different going forward. Uh, we're looking at, uh, maybe reducing how many people come back and maybe, uh, allow more and more people to, uh, to telecommute, maybe full-time, maybe share cubicles, have, uh, managers, share offices.

You we're working through all of that right now. Some areas are, are actually outperforming their work prior to Covid because they don't have to commute and so forth. And where the, where we have good KPIs, I think we have to take a strong look at maybe reinforcing a much more aggressive telecommuting, uh, uh, posture, uh, within our organization.

Yeah. Well Patrick, thanks for your time. And by the way, I really like your, your home office. It's it really nice

hunkering down up in Big Bear Lake is, is a great place to, in my cabin up. So I'm, I'm very happy to, uh. From the city, but uh, long up at you, it's love love's. Thanks. Thanks.

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