It’s hard to think about anything good coming out of this pandemic. Every story of a life lost is heartbreaking. Like you, I have shed many tears in the past month as I read and heard their stories.
And yet, it is encouraging to consider some of the positive changes we may see when we get to the other side of this crisis and are living and working in the “new normal”. We don’t yet know when that new normal time will come. But there are changes in healthcare and how we work that will hopefully be long lasting. I’m not talking about the overall healthcare system or macro societal and economic changes – I’ll leave that to others.
From a health IT lens, here’s my take on some of the positive changes:
Telehealth – There is no question that this crisis has led to a huge increase in telehealth and new use cases. Some organizations are seeing 50+ times the number of telehealth visits compared to before. With regulations relaxed and no alternative, telehealth is being used in many different scenarios. Training, broad deployment and adoption has accelerated as clinic visits are cancelled and telehealth becomes the primary means to connect with your physician. And on the frontlines of COVID-19 hospital care, leveraging it with inpatients to protect staff and reduce the amount of PPE used has also become common. We’ve reached the tipping point for telehealth and I expect we’ll see it continue to grow in the future. A recent article in NEJM Catalyst by Judd E. Hollander, MD, and Frank D. Sites, MHA, BSN, RN, titled “The Transition from Reimagining to Recreating Health Care Is Now”, covers how organizations need to look at expanded telehealth use post COVID-19.
Rapid deployment – From an IT perspective, supporting the effort to stand up a field hospital or alternate care site such as the 1000 bed Boston Hope Medical Center is like a “greenfield” hospital compared to rolling out a new EHR and the associated infrastructure at an existing hospital. What lessons can be learned and applied from these rapid deployments when it comes to getting all hospitals in a healthcare system on a common platform? Does it have to take years?
Interoperability – I use this term loosely here. New York considers all hospitals statewide as one system to share resources and staff. The Hospital for Special Surgery (HSS) in New York City quickly transitioned from an orthopedic only hospital to take other surgical cases and COVID-19 patients, credentialing physicians and providing access to systems. While state and regional Health Information Exchanges (HIEs) have varied in their successes over the years and physician credentialing is one of the slowest and most tedious administrative processes in healthcare, it gives me hope to see how effectively and quickly hospitals are working together in a time of crisis.
Workflow changes – With EHR systems it can often take weeks or months to identify requirements, reach consensus, make the changes, test, train, and implement. Those changes are now measured in hours or days if it’s needed for COVID-19. IT teams and their clinical partners should ask what processes can be streamlined when we are in the new normal.
Data analytics – Collecting and using data for predictive analysis and decision making is critical during this crisis. Ensuring data governance is addressed and investing in analytical capabilities, both tools and people, will likely get more attention in the future. Dale Sanders, CTO at Health Analytics provided great insight on the analytics needed during this pandemic in a recent This Week in Health IT interview – Data vs Pandemic.
Agility, teamwork and speed to solution – Stories abound of how IT teams with their clinical partners and suppliers have identified needs, accelerated decision making, collaborated and delivered innovative solutions in record time. In their This Week in Health IT COVID-19 Field Reports, Jamie Nelson, CIO at Hospital for Special Surgery, and Phyllis Teater, CIO at The University of Ohio Wexner Medical Center, talked about the agility of their teams and how quickly they have been able to deliver solutions during this crisis.
With so many people working from home now, here’s my take on some of the positive changes across all industries with a little healthcare spin because it’s what I know:
Work from home – In a matter of days, millions of people were asked to work from home. IT teams everywhere ensured people had the tools, connectivity and security needed to effectively work from home for the foreseeable future. Management figured out how to keep people connected and productive. Organizations will learn from this how many people can work from home on a full-time or near full-time basis with periodic onsite days.
Collaboration tools – Organizations are often slow to transition to and fully adopt a standard collaboration tool as they meet resistance to change from employees. But the new world of work from home makes it a necessity. The story of Northwell Health’s use of Microsoft Teams for their daily emergency operations center calls is a great example of why these tools must be adopted.
Video conference calls – In the past it was maybe just a few people calling in from remote locations while everyone physically together in the conference room got frustrated and impatient with the technical difficulties that often occur. At this point, for all those working from home, who hasn’t figured out how to ensure their audio and video works well and how to share their screen? In the future, organizations that are spread across large metropolitan areas or regions may invest in infrastructure for video conference meetings as the norm to reduce local travel from multiple locations and parking hassles as well as accommodate more people working from home.
Consulting firms and travel costs – I’ve heard about EHR implementations staying on track with workflow walkthroughs and Go Live Readiness Assessment (GLRA) sessions being conducted virtually in the past month. Think about the travel costs and time that could be saved if more work by consultants was done virtually.
Virtual/online training – While K-12 teachers and schools have had to quickly adapt to an online learning approach, the colleges and universities didn’t have as big a transition. What can be learned from them for future training approaches? For example, will organizations implementing a new EHR have to send all their analysts to onsite training at the vendor’s location in the future?
Yes, organizations have cut corners and removed barriers out of necessity during this crisis. It’s up to all of us to ensure that what we have learned during this crisis is appropriately applied when we collectively get to the new normal. Healthcare providers are already seeing the financial hit as they cancel elective surgeries and clinic visits. Cost cutting measures are in process and will continue. Many of these positive changes could contribute to reducing costs.
Laishy Williams-Carlson, CIO at Bon Secours Mercy Health, summed it up well in a Becker’s Hospital Review interview – “As we return to a ‘new normal,’ we must appreciate the radical disruption that has occurred and implement the best aspects of the new care model, including remote work, new uses of virtual visits, and rapid deployment of minimally viable products which value speed over perfection.”
Be well. We’ll get through this together and create a better new normal.