Tag Archives: Coronavirus

With gratitude – yes, even in 2020

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Difficult as 2020 has been, it is my hope that each of us can find something to be grateful for this Thanksgiving. If you have lost a loved one to COVID, I know that no words can take away your pain and grief. If you are a “long hauler”, I hope that you are finding support from others as you navigate your ongoing health issues. If you have lost your employment due to the economic downturn, I hope you are finding support from your network to find a new job.

Many times, during the past 9 months I have said to my family and friends – I can’t complain, I’m healthy and alive. I never really felt my age, but since March I have been reminded that I am an “elder”. I am overall healthy with no underlying conditions but I’m in that over 65 group. My husband is 4 years older than me and does have some medical conditions. We have been mask wearers since mid-March and do our best to minimize our risks.

I have much to be grateful for. Healthcare workers caring for COVID patients on the front lines and scientists working to develop a vaccine. All those who support them in ways we see and don’t see. And yes, that includes the IT and HTM teams in every health system who provide solutions and systems that the clinicians depend on.

I am also grateful for all the essential workers – at the grocery store, providing public transportation, delivering packages, and the police and firefighters who protect us.

My family are my big rocks. And that has never been truer than this year. I am eternally grateful for them. Continue reading →

Well past time to support our healthcare workers

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Any graph or heat map you look at, one thing is obvious – the coronavirus is out of control and spreading rapidly. New coronavirus cases have jumped by more than a third in the U.S. over the past seven days, according to data from Johns Hopkins University, the fastest pace since late March. Every day since Election Day, more than 100,000 people in the country have tested positive for the virus with a daily record of over 187,957 new cases last Friday per Worldometers.info. We went from 10 million new cases to 11 million in just one week. And we have lost over 250,000 lives.

We saw heartbreaking stories on the news from ICUs in the Northeast during March and April. Then stories from southern states. And now from hospitals in the Midwest. But when you look at the heat maps, the virus is everywhere now.

Listen to any healthcare worker and one more thing is obvious – they are exhausted and burning out. They tell story after story of how hard it is to work 12- and 18-hour shifts caring for COVID patients only to drive home past crowded bars.

We have seen exhausted physicians and nurses share their stories for months. I cannot tell their stories, but I can share them. And I can encourage you to do the same. But more importantly, I can encourage you to take the basic steps needed at this point – messages we have all heard for nearly 9 months now – wear a mask, socially distance, and wash your hands frequently.

This virus is not a hoax. It is not something you can ignore or deny. A story from a nurse in the Dakotas is the latest to go viral. She describes patients who yell at her and say she does not need to wear PPE because they don’t have COVID, right up until they are intubated.

Our healthcare workers truly are heroes, but they are at a breaking point. Our hospitals are at or nearing capacity. There are over 73,000 people hospitalized with COVID, another record since the pandemic started. Field hospitals are opening again in many states. Continue reading →

COVID-19: The good, the bad, the different

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When it comes to COVID-19, there is little good. But every report that reflects progress is good news. Whether it is progress in how best to treat hospitalized patients, progress towards a vaccine, or the number of new cases, hospitalizations and deaths trending downward. I saw one of those reports just a few days ago when Shereef Elnahal, President and CEO, University Hospital in Newark, New Jersey shared their good news on social media:

“We made it.

For the first time since the #covid19 pandemic started, University Hospital has ZERO patients with coronavirus in house.

After over 1,000 discharges, leading northern NJ’s regional response, and folks in the City of Newark wearing masks, socially distancing, and getting tested, we hit a milestone that we’ve been hoping for since a time when almost every patient in our hospital had coronavirus.

So proud!”

There are probably many more hospital leaders in the Northeast who can finally report this same good news. And they have reason to be very proud of what they and their teams have done for their communities.

But there is plenty of bad. A health crisis with nearly 200,000 deaths and a projection that there could be over 400,000 deaths by the end of the year. An economic crisis with millions unemployed.

Another evolving bad news story is what we are learning about the “long-haulers”. These are people who had COVID-19 and months later report a variety of long-term symptoms. Continue reading →

A different kind of summer comes to an end

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If you were a fan of Downton Abbey and remember the Maggie Smith character, the Dowager Countess of Grantham, you may even recall how she said in her aristocratic way, “What is this thing you call a weekend?”. For the landed gentry of England who didn’t work, what did a weekend mean? For those of you working from home, dealing first with home schooling and then kids on summer break, and with vacation trips cancelled, you may ask the same question. But it’s because every day seems to run into the next during this pandemic.

As we approach the final summer holiday and three-day weekend we know as Labor Day, hopefully you won’t have to “labor” but can actually take a break. In the health systems I worked at, August was the big vacation month – especially in the academic medical centers. When I was CIO at Brigham and Women’s Hospital, one of my VP colleagues would remind us that after Labor Day it is a sprint until the holidays in December. He’d say let your family know how busy you’ll be and be sure to take a break in August somehow.

With a trip to Disney with grandkids and a European trip cancelled this year, my husband and I feel like one day just rolls into the next as I’m sure many of you do. I’ve written in the past about the importance of making time to reboot and the 6 R’s of summer. But this year is different. I only hope that all of you and especially those on the front lines of this pandemic have found time for a much needed and well-deserved break, somewhere, somehow.

If you are feeling overwhelmed at times, this article by Tara Haelle may resonate with you – “Your ‘Surge Capacity’ Is Depleted — It’s Why You Feel Awful”. It describes our personal “surge capacity” and how to manage through these times. Continue reading →

Staying fit and informed

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If you are working from home during this pandemic, getting enough exercise each day can be a challenge. I spoke to a CIO colleague recently who said he used to get 10,000 steps a day just at work given the size of his office complex.

I recently decided that I needed to up my exercise routine to ensure I get 10,000 steps a day. A long dog walk at the end of the workday plus the steps inside my house from my home office to the kitchen and back are just not enough. While I have never been an early morning exerciser, I am now two plus weeks into a new routine. Instead of rolling out of bed and starting on email and work right away, I now go for a brisk walk. I try to do a minimum of 30 minutes but depending on the time of my first scheduled call of the day, I do anywhere from 20-45 minutes. The end of day dog walk rounds it out to ensure I hit my 10,000 steps.

Besides the physical and mental health benefits of more exercise, I also have more time to stay informed via podcasts. A few weeks ago, I wrote about my latest podcast recommendations. With my new exercise routine, I am ready to recommend two more:

The Osterholm Update: COVID-19 – If you had not heard of Dr. Michael Osterholm pre-COVID, you probably recognize his name by now. Continue reading →

Time to reimagine industry conferences

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Large gatherings such as sporting events and concerts seem impossible to return prior to a vaccine and treatment for the coronavirus. Yet alternatives are being considered and reimagined. In the business world, industry conferences and conventions are in that same large gatherings bucket. So, they too should be reimagined.

Scientists and public health officials would say do not plan on these types of events until sometime in 2021. I do not want to minimize the challenges and complexities involved in these decisions and plans. But I do believe that leaders everywhere must trust science to keep people safe.

The American Telehealth Association (ATA) held a virtual conference last week. Of course, if any organization should be able to successfully pull off a virtual conference, it is the people who do telehealth.

But I am fresh off an entirely different virtual conference experience and I could not be more impressed with what they did and what is possible. It was not an organization in the tech industry but rather a faith community. I am a Unitarian Universalist (UU) and our annual church conference (General Assembly or GA) is held each June. The Unitarian Universalist Association (UUA) board made the decision in March to not cancel but rather to go all virtual.

This meant they had to pull off a five-day conference that included large general sessions, discussion/debate on resolutions, delegate voting, workshops, poster sessions, worship services and special collections – all virtual. The result was higher attendance (close to 5000 registered) than many in-person conferences in past years, education and discussion on everything from spiritual practices, to congregational growth, to anti-racism organizing, and to getting out the vote in November. While people missed the hugs and hallway conversations, it was an overall positive experience for thousands of UUs.

That same UUA leadership had the foresight back in April to advise all congregations to plan on virtual Sunday services through May 2021. UU congregations all over the country are adapting to virtual services as the new normal and they are doing so in varying and creative ways. Many congregations report higher “attendance” than in the past.

The lessons are clear – it is time to reimagine and embrace the virtual world we now live in where we can. If planned and executed right, little is lost and much is gained.

So back to our health IT industry. What does the typical lineup of Fall conferences look like? Continue reading →

Year of the Nurse: We must support our nurses

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The first time I cried during this pandemic was March 17 when I read that in Italy people over 60 years old were being left on gurneys in the hallway to choke on their own sputum. Patients with coronavirus had

Message from Brigham and Women’s Hospital OR nurses: #StayHome

exceeded the hospitals’ capacity. I had been watching the news and stories from Italy closely in anticipation of what was going to happen in our country assuming we were just a few weeks behind them in this crisis. I cried then not only for Italy but for myself. I wondered if I was going to be one of those over 60 left to die if our hospitals were also unable to handle the potential number of very sick COVID-19 patients.

The second time I really teared up was when I thought about my daughter who is the Chief Nurse Practitioner (NP) on the inpatient orthopedic/spine service at Brigham and Women’s Faulkner Hospital in the Boston area and reassigned to work shifts in the ICU with COVID-19 patients. I feared the worst for my family. That she would get exposed and transmit it to her husband and five-year-old daughter who both have very bad asthma and are allergic to almost everything. We knew this virus was not just killing elders. People of all ages and especially those with underlying conditions were and are still at high risk.

Most of the times I have had tears since then has been watching a nurse or physician tell their story on the news. Describing what it is like to care for intubated COVID-19 patients, helping their patients’ families understand there is nothing more they can do, and sharing the fears they have for their own families when they go home from their shift. I have also cried when I see the stories of family members dying within days of each other from this virus, many of them people of color who are essential workers who can’t stay home.

I have listened to my own daughter describe the days she was assigned to work an ICU shift with COVID-19 patients. While it was not the overall intensity of what we have seen on the news in New York City hospitals, every individual case she described was just as sad and heartbreaking. And the emotional and physical toll on the nurses, doctors and respiratory therapists was obvious.

On the brighter side of this crisis, I have smiled with joy as healthcare workers in NYC celebrate the 500th or 1000th COVID-19 patient discharged from their hospital. Continue reading →

What next for health IT?

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Two weeks ago, I wrote about looking ahead to the “new normal” post COVID-19. Since then some states have started slowly re-opening while other states are defining what their phased re-opening approach may look like. Hospitals have started to develop plans to expand their services beyond emergencies and COVID-19 patients – performing elective surgeries and opening outpatient clinics. All of this is new territory. Patient scheduling, workflow changes, and appropriate staffing and PPE to provide safe care must be accounted for and planned for very carefully. This will happen over the coming weeks and months.

Given the financial impact COVID-19 is having on healthcare systems, executives also need to be looking at how to position their organization for not just recovery but long-term success. One of the articles that I have seen on this is a white paper published by the Chartis Group – “After the Surge: Five Health System Imperatives in the Age of COVID-19”. In it they discuss how COVID-19 has fundamentally changed the care delivery landscape. They outline what they consider to be the five imperatives for future health system success:

  1. Engage consumers and other referral sources to recapture patients
  2. Fundamentally reduce the cost base
  3. Restructure the physician enterprise
  4. Transform the clinical operating model
  5. Closely evaluate partnerships, both horizontal and vertical, traditional and non-traditional

Other management consulting firms that work with healthcare providers most likely have a similar analysis and framework. Regardless what they may look like, all of these long-term efforts will require IT support. Continue reading →

Looking ahead – the “new normal” post COVID-19

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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. Continue reading →

How daily life has changed

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Whether you live in a state with strict stay at home orders from your governor or are still going about your life with few adjustments other than social distancing and more frequent hand washing, your life has changed.

You may be an essential worker reporting to your workplace each day or adapting the best you can to working from home or fearing a layoff or already out of a job at this point.

You may have elder parents living with you or other family members with health issues that make them high risk.

Regardless, your life has changed. The fears, uncertainty, anger, sadness, exhaustion, confusion, and so many other emotions and feelings are real. We all have them.

Self-care is important for all of us. As a CIO/CMIO colleague keeps telling his team, it’s a marathon not a sprint. The image I used this week is one of my favorites shared on Facebook by Brooke Anderson, a photographer in California. It’s a good reminder of how we need to take care of ourselves..

Here’s what my daily life looks like now:

  • Staying at home: My husband and I haven’t been anywhere in 2 weeks except for when I picked up takeout at a local restaurant over a week ago.
  • Working from home: Splitting time between our StarBridge Advisors business and work with a health system client on a variety of projects.
  • Exercise: Walking our two little dogs and trying to get 10K steps each day keeping appropriate social distance with all the other walkers. There is a joy in seeing the spring flowers and buds on trees change each day – gives me hope!
  • Family connection: Talking to my sister in Minnesota where I grew up and where all my three siblings and their families live. Keeping in touch with my daughters and their changed lives. One daughter is a Nurse Practitioner who will soon be caring for COVID-19 patients while her husband adapts to working full-time from home and their 3 and 5-year-old kids play together. The other daughter was already working from home; her husband is adapting to working from home while their first grader is doing the eLearning school program and their 5-year-old plays.
  • Sharing resources: It’s hard to not be in the thick of it knowing what healthcare organizations are going through and how IT teams are working hard to support them. I’m channeling that energy into supporting Bill Russell and “This Week in Health IT” with a growing number of free COVID-19 resources for health IT teams.
  • Social media with a purpose: I try to share what is most informative and useful as well as positive and motivating.
  • Managing how much news I watch: On my busiest workdays I only watch at night. On more flexible days, I get snippets mid-day. In the spirit of being positive, I will say that the leadership demonstrated by New York Governor Andrew Cuomo is the leadership we need at all levels of government – fact based, informed, action oriented, and empathic.

And as the days blend together, the weekly routine now includes a couple new things. We gratefully receive grocery delivery that our nearby daughter has helped coordinate. We do a weekly family video call where the four grandkids stick their face right up to the camera and call out to their cousins then eventually go play so the six adults can talk and check in with each other. And we make a quiet moment to do Sunday online church which are YouTube messages from our ministers that we can watch anytime.

No matter what your days look like now, practice self-care. There are many resources out there to support you. The latest This Week in Health IT podcast – “Mental Wellness During Crisis” with Dana Udall PhD, Chief Clinical Officer at Ginger is definitely worth listening to.

Whatever you might fear or feel inconvenienced by during this pandemic, think about the healthcare workers who like firemen run into the burning building, not away from it. They are going to work so we can stay home. They and all the essential workers who are keeping things running are the true heroes. To them I say thank you, be safe and well. To all of you, take care of yourself and those you love. We will get through this – together.