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May 27, 2020: For today’s episode of This Week in Health IT, we sit down with Albert Oriol, who is the CIO of Rady Children’s Hospital in San Diego. Rady Children's Hospital-San Diego is the largest children's hospital in California and provides services to the San Diego, southern Riverside and Imperial counties. In this episode, Albert gives us his perspective on how the county and Rady have handled the COVID-19 crisis. We discuss remote working arrangements and how they may change the working environment at Rady coming out of the pandemic, and Albert tells us about some of the adjustments that Rady has made to keep staff and employees safe. Albert also shares how Rady works with other health systems and hospitals in the county, and why they are preparing to treat young adults if there is a surge in cases. Finally, we talk about the technological, genealogical, and logistics developments Rady has made during the pandemic, including increased telemedicine. Tune in today!

Key Points From This Episode:

  • Abert’s perceptive on how San Diego and Rady has handled COVID-19.
  • Remote working arrangements for Albert and how Rady has upped video conferencing.
  • How the working environment might change coming out of the pandemic.
  • Adjustments to Rady’s remote working conditions for staff and consultants in the new normal.
  • How Rady works with other health systems in the county.
  • Why and how Rady is preparing to treat young adults if the need arises.
  • Technology developments at Rady, including telemedicine and drive-through testing.
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 where we amplify great thinking to Propel Healthcare Forward. 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. Have you missed our live show?

It is only available on our YouTube channel. What a fantastic conversation we had with, uh, direct Ford David Mutz. S Shade. Around what's next in health. It, uh, you can view it on our website with our new menu item appropriately named live. Or just jump over to the YouTube channel. And while you're at it, you might as well subscribe to our YouTube channel and click on Get Notifications to get access to a bunch of content only available on our YouTube channel.

Uh, live will be a new monthly feature only available on YouTube. How many times did I say YouTube in that paragraph? Subscribe to YouTube. We're gonna have some great stuff over there. This episode in 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 Alberta Orel, the CIO for Rady Children's Hospital in San Diego. Uh, good afternoon, Alberta. How are, how are, uh, how are you doing? I'm, I'm great, bill. Thanks for, thanks for having me here.

How are you doing, uh, ? I'm, uh, I'm, I'm doing pretty well. This, you are the like 36th, so 37th interview. We. Uh, we usually do two shows a week. We've now done one a day for the last, uh, four or five weeks, and it's been great to talk to people in your role and just hear the, the amazing work that's going on.

And, you know, let's just start there. I mean, give us a little context of what's going on in, in San Diego and what's going on specifically at Rady's. Well, so, so I think, uh, overall San Diego with, with this, uh. Uh, kinda crazy, uh, novel coronavirus, uh, situation that we're all facing. Has, uh, overall done very well.

I think our public health authorities got into this early on and set up, uh, all the, uh, the kind of preventative measures that we've seen. Across the country. They, they got jumped on it early on, as did the California governor. And, and, and we had been, uh, uh, planning as well. So I think all in all, the region is doing great.

The, uh, San Diego is doing is doing, uh. Great in terms of containing, um, the threat, if you will, and, uh, Rady Children's is doing fantastic, uh, both from a, from an IT standpoint, but, but, uh, as well from an overall organizational standpoint. And, and it's been just incredibly uplifting to see how everybody's pulled together to, to, uh, plan and execute and get ready for something that fingers crossed.

We hope, uh, stays at bay, but, uh, that, uh, we're ready to, to tackle if, um, if and when it, uh, it shows its, uh, its teeth. Yeah. So gimme, gimme an idea of some of the things that you guys did. I, I noticed you're in the office. Uh, did you, did you really ramp up the work from home and the, and the, the telehealth for, for a children's hospital?

Uh, absolutely. So when, when, um, when the stay at home order came, uh, in, uh, San Diego and in California, so the schools, uh, I think announced on, on, uh, March, uh, was March 10th or 13th or something like that, that, that, um, they, uh, they were not, uh, going to, uh. To reopen for a while, so, so, uh, we put, uh, pedal to the metal to ramp up our work from home.

Efforts. Uh, we went from having somewhere around 50 to a hundred, uh, uh, people working remotely at any given time to now having close to, uh, 2000 people that, uh, that work remotely on any, on any given day. Maybe, uh, maybe, uh. Even, uh, 2,500 that, that, uh, are working remotely. I think, uh, some of us are taking turns.

They, we, we work some days from home, some, some days here. As, as you would expect. I have members of my team both are. Biomedical engineering team, as well as my end user services team that, that the network team that need hands-on, uh, to continue to provide, uh, support because, uh, the operations of the, of the institution continue and, and things break or things need to get installed and, and, and they need to be here.

And, and I think it's important for me to, to spend some time of my, of my, uh, working week here. Uh, to provide the support to, to, to, uh, to do whatever I need. And, and the other days I work from home and, uh, and it, it works. Uh, it, it works great. Uh, it's, uh, it's a good balance and I think, uh, we're going to, to see, uh.

Uh, an interesting, an interesting future when everything is said and done, um, but, uh, work from home, tremendous, tremendously. Um, uh, change. I, I was asking, uh, one of my leaders earlier, how are we doing, for instance, on, on video conferencing? Um, and, uh, what, uh.

And April, we, he just picked a day and, and happened to pick April Ssay last year. We, I think did in total of, uh, 19,000 minutes of video conferencing. And that same day this year, we, uh, we did 10 times that. Oh gosh, that's, so I, you know, I've sat in that traffic in San Diego. I mean, do you think the, there's two questions really here.

Do you think the work environment will change coming out of this? That's probably one question. I. You know, I, I imagine some of your staff is gonna be listening to this, so you might wanna be careful how you answer. But the, the other question is, do you think consulting will change coming outta this? Do you think you'll think differently about consultants?

Consultants may be, you know, working from. I'm working on a project for you from New York or from somewhere else. Uh, great, great question. Thank you. So I think, um, we have, we have had a portion of our workforce that's worked remotely for years and, and some of that has been, I. Uh, because, uh, they've had life circumstances.

As you know, San Diego, uh, has a big, uh, navy and Marine, uh, presence and, and, uh, a significant portion of our staff have, uh, spouses in the military and they, they move every three years or whatnot. And so we've been, uh, rather flexible when it's come down to, to enabling people to work, uh, remotely. Uh, understanding that not everything can be done.

Uh, remotely, but, but we've, we've been, uh, kinda on that bandwagon early. Uh, and what, what I anticipate is that that is something that now will get augmented, uh, at some point. I dunno to what extent, but, uh, because we're, we're having an opportunity or, or a necessity to stretch what we were doing, uh, beyond what we were doing.

And we're seeing what areas actually work well and continue to work well. What areas, you know, it are, are, uh, something that, you know, we can, we can. Get by, but, but we're, but it's not ideal and, and so I anticipate we'll see. Uh, continue to adjustment on that for, for a while when it gets back down to the new normal.

And, and I think the same is true with consultants. We've, we've used consultants, uh, remotely for, for a while as well. And, uh, and what I can tell you is when I come to the office, my commute time has, uh, been cut in half and that is.

So, um, gimme an idea of how you worked with the other health systems. So you're in between, uh, sharp Scripts, uc, uh, are all down there. I mean, that, that's pretty much most of, uh, the healthcare in that, in that market. How did you work with them? I, I assume you worked pretty closely to talk about how the children's cases are gonna be handled and.

And coordinate that somewhat, you know, I'm just curious how you worked with those other health systems. Yeah, absolutely. Sore Children's is both the safety net and the provider of choice for pediatric care in, in San Diego, and we take care of over 80% of the, of the kids in the, in the county. So for the most part, uh, that, uh, traffic comes our way regardless for the, the designated trauma center, et cetera.

So. We, we can already do that. We have, uh, a number of, of, uh, NICUs that are embedded inside the adult hospitals in the region. Uh, we have a pediatric unit also embedded in. In, uh, in, uh, a local, uh, sharp hospital, et cetera. So we partner, we're we like, we like to, to, to say we're the Switzerland of pediatrics in San Diego, and we, we work very closely with all the, uh, with all the adult ho uh, health systems in, in the region.

Now for, for Covid, as you know, uh, it's one of those blessings, uh, that, that the pediatric population seems to have. Majorly spared. Uh, and so, um, you know, not that. Those, uh, kids with chronic conditions or, or some underlying, uh, conditions that make them su susceptible are, are not addressed? They certainly are, but, but for the most part, uh, I think unlike other viruses, this is not one that, that, uh, is, uh, is targeting, uh, kids.

And, and so what we're doing is. We've planned to be able to extend the age of, uh, of people that we can care for, uh, so that we can, uh, take over, uh, the younger adults if need be. Uh, if, if the search presents in the adult hospitals, we'd be able to take, to take on, uh, some of the younger adults here. Um, but uh, the reality is right now, like so many other

Uh, health systems, uh, certainly in San Diego, but, but in other areas of the country, uh, volumes are low. And, and, and because I think everybody's being, uh, very responsible in, in managing the situation. We're not seeing the surge that, um, that is being seen in New York and some of the other areas. And, and so, um, I just know when.

Uh, extension would need to be activated just in case we're ready. Yeah. So what give, give us an idea on, so it's this week in health, it, I'd be remiss if we didn't delve into this a little bit. What are some of the things that you did from a technology side that you know would be, uh, that people would be interested to, or even amazed that, that your team has been able to accomplish?

Yeah. Well, I think, like, like so many others, my, my, my team, I can't speak highly enough. Of of them, they're, it. It's just been an amazing, uh, uh, side to see how everybody's pulled together and kind of burned the candle on both ends of the stick to just, uh, enable this organization to con, to continue to function.

But I will tell you the week after the same place. Uh, or the week when the stay in place order came through, uh, our volumes just tanked. And, um, uh, it's been, uh, it to the rescue to some extent whereby we went from doing, uh, maybe a handful of telemedicine visits, uh, on a daily basis. We're now doing . Uh, about 800 visits a day on telemedicine.

So, so, um, we're, we're 75% of our ambulatory care right now is being provided through telemedicine. Uh, that equates to about 30 to 35% of our. Of our normal, what would've been our normal volume. But nonetheless, it's, it's, uh, it's been, uh, it's been a saving grace to continue to provide care for, for kids that need it.

Right. Uh, one of the big concerns with this is that, is that necessary, uh, care, whether it's vaccines or whether it's, whether it's, uh, just monitoring of kids with chronic. Or, uh, checking to make sure that, that those who do need to come in, uh, come in, uh, rather than waiting for a condition to, to exacerbate, et cetera.

That, that it gets caught early. Um, that, that is being, um. It's continuing to, to be enabled. Right? So, so that's been brilliant. Uh, on, on the, uh, testing side, for instance, uh, our, uh, genomics Institute, um, has, uh, stood up a, uh. A testing, uh, what we call a covid, uh, mass testing, that that is available as a drive-through, uh, function.

And, and, and so that's, that's, uh, something else that, that we were able to stand up, uh, and in, in, uh, record. Uh, time and, and, and work through, through those processes. Not, and not only to, to be able to, to capture that information, but then, uh, to make results available to, to the county. Uh, so it's, it's been just, uh.

Short of, of, uh, incredible. I, I, as I say, the, the collaboration across, across the house, uh, the clinical, the logistics, the, the, it has been, uh, fantastic. Yeah, that's, that, that is fantastic. And we, we will have to have you back on the show. You, you, you, the things you guys are doing at Rady's around genomics is really exciting.

I'd like love to talk about that. Uh, and you know, it's just San Diego I think is, is one's so much great stuff on in healthcare.

Appreciate, uh. Love the uh, mask too, by the way. Yeah. Thank you. Yeah, I'll try to not go rob a bank now, . Appreciate it. Take care. Alright, thank you Bill. It was nice talking to you. Thank you for having me. That's all for this week. Special thanks to our sponsors, VMware Starbridge Advisors. I. Galen Healthcare, health lyrics, serious healthcare and pro talent advisors for choosing to invest in developing the next generation of health leaders.

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Uh, please chip back often as we will continue to drop shows until we get through this pandemic together. Thanks for listening. That's all for now.

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