Tag Archives: Covid-19

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 →

Physical distancing: finding our way

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We saw our grandkids again on Sunday. A small family get together for Father’s Day and our youngest grandchild’s 4th birthday. As we all find our way and do our best to minimize our risks of COVID-19, being able to hug my grandkids brings me great joy and is one of the things I have missed the most these past few months.

There is a reason many people want to refer to this new practice as physical distancing, not social distancing. We need each other. Social isolation is not healthy. Technology has helped but it is not the same. Just ask someone who said their final goodbye to a loved one on FaceTime or Zoom.

Living in Rhode Island, my husband and I have taken the shutdown very seriously. Governor Gina Raimondo got ahead of it early with the shutdown order and then a slow, phased reopening. From mid-March until a few weeks ago, we have mostly stayed home except for the weekly groceries, a few trips to the garden nursery and Home Depot, the occasional takeout order, and the daily dog walks.

We limited family visits to outside spaces at our homes at a distance and no hugs. We are gradually loosening up on the hugs. As we all learn more about how the virus is transmitted, spending time with close family who have also been strict during this period seems reasonable.

My 4-year-old grandson first told me back in April on a family Zoom session that he was going to have a birthday parade, no gifts, and a small cake only for his mom, dad, and sister. It was sad to hear him explain this at such a young age but I thought it was probably a reasonable plan. The idea of a parade was exciting to him. But two months later we decided it was ok to do the backyard immediate family only gathering, which was 12 adults and the 4 young cousins, aged 4 through 7. The grandkids gave us hugs and briefly sat on our laps. It was good to not feel like we were all radioactive.

The slow opening of our own circles is a challenge we all must deal with. I do not take this virus lightly. I read a lot and listen to many interviews and podcasts with experts. I try to be as informed as possible about the science. And I take cues from my sister who has a public health background and my daughter who is an NP and has cared for COVID-19 patients in Boston. Continue reading →

At the intersection of racism and healthcare

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It has been two weeks since George Floyd was murdered by police in Minneapolis. Since then, millions of people have joined protests in major cities and small rural towns around the world to make their voices heard. They have said enough is enough, racism must end and real change is needed.

When the protests end and our national focus begins to shift, we can not go back to business as usual. The statements of support and solidarity made by so many these past two weeks must turn into action.

At the local, state, and federal level we must hold our government leaders accountable for change and exercise our right to vote for those committed to change. With the focus on police brutality, we are beginning to hear some major cities announce planned changes in policing. New York Governor Andrew Cuomo has introduced his “Say Their Name” agenda to reform policing in New York state. House and Senate Democrats have introduced the Justice in Policing Act.

In recent days, we have seen many “white coat” rallies as well – White Coats for Black Lives. My social media feeds are filled with pictures and stories of hospital staff rallies – many of them organized by the residents. Brigham and Women’s Hospital in Boston, UMass Memorial in Worcester, Massachusetts, and Henry Ford Health System in Detroit were just a few of them. And these are hospitals who saw thousands of COVID-19 patients in recent months. Truly our healthcare heroes.

In 2014, after Michael Brown was shot by police in Ferguson, we saw similar support. Students at 70 medical schools around the country organized a national white coat die-in saying it was an “important time for medical institutions to respond to the violence and race-related trauma that affect our communities and the patients we serve”. They lay down for fifteen and a half minutes. Eleven minutes to represent the number of times that Eric Garner said “I can’t breathe” as he was in a choke hold by police in New York City and four and a half minutes to represent the four and a half hours that Michael Brown’s body lay in the street after being shot by a police officer. And yet here we are in 2020.

These hospital staff rallies along with the many statements of support from hospital and health system CEOs are an important show of support but we also need action and attention to health disparities. I want to share two heartfelt CEO statements that were the most impactful for me. They are from healthcare leaders I have worked with and greatly respect. Continue reading →

Hospitals too are part of a safe reopening

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This past weekend was the unofficial beginning of summer. After 2+ months of stay at home orders and a few weeks of phased reopening depending on the state you live in, the images of large crowds packed in close and without masks at a pool in Missouri, on the boardwalk in New Jersey and at a race track in North Carolina were concerning. As I hope many others chose to do, we stayed home and had a family visit on our patio at a social distance.

We are hearing stories of super spreaders from Mother’s Day two weeks ago resulting in upticks of COVID-19 cases in many states. We see stories of a hair salon in Missouri where two stylists who were ill exposed over 140 customers. We see stories of no available ICU beds in Montgomery, Alabama where cases have reportedly doubled since that state reopened two weeks ago.

On Friday, the President ordered churches to reopen and threatened to override governors who refused to do so. Fortunately, many faith leaders acted responsibly and outlined plans for continued online or outdoor services until they are certain that they can safely reopen their doors to congregants.

News reports say the virus is still spreading at epidemic levels in 24 states and is not contained. This pandemic is not over. And it may be a long time before it is. So how do we begin to recover and safely reopen? 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 →

IT requests increase while budgets decrease

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As hospital systems develop their COVID-19 recovery plans, the financial impact of this pandemic is deep and far reaching. IT budgets are no exception. IT leaders are being asked to take salary cuts, furlough staff, and deal with a capital freeze for the rest of the year. This comes at a time when the demand for technology solutions is only increasing. And at a time when IT teams have performed at their peak in providing and supporting new solutions with agility and in record time.

In a recent Becker’s Hospital Review article, Hospital IT Spend Pivots to Mission Critical Projects: 7 Leaders on the Key Focus for the Next 12 Months, IT leaders covered telehealth, digital transformation, analytics, informatics, and of course the reality of cost reduction facing them and their organizations.

IT leaders have long faced the supply vs demand challenge. And they have long faced the need to reduce their budgets while meeting a growing user base and increased demand for technology solutions. The days of significant year to year budget and staff growth in IT are a distant memory.

As we look to the future after the COVID-19 recovery, some people talk about the “new normal” phase and others refer to it as the “re-imagine” phase. The latter certainly encourages us to think differently. Regardless, it will be with far less resources. So how does IT manage and ensure success in this ever more constrained environment? 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 →

Leading through a crisis

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As a leader, you are called upon to lead in good times and bad. At normal times and when there is a crisis. It may be an incident in the community with mass casualties, a natural disaster, or a widespread pandemic as we are living through. Barring any of these truly awful crisis, it might be a system failure and as an IT leader you are front and center. Whatever crisis you may face, it requires the best of your leadership skills.

Here is my list of the needed skills from my own experience and watching the best leaders in our current global crisis.

  • Communicate often to everyone involved and impacted. Be open and transparent.
  • Focus on the facts. Be explicit when you are stating opinion instead of fact.
  • Own the situation. Don’t make excuses. Take responsibility.
  • Be genuine and empathetic. Stay connected.
  • Stay calm and project calmness.
  • Be available and present. Stay close to your team. Provide the encouragement they need.
  • Listen to the input of others, especially the experts.
  • Be adaptable and ready to make quick decisions.
  • Lead by example in all you do.
  • Let your organization’s core principles guide you.
  • When you can, look ahead and past the crisis. Develop a return to normal plan
  • Capture lessons learned.
  • Express gratitude often. There are many heroes in a crisis. Find them and thank them.
  • And don’t forget to take care of yourself.

I have heard many health IT leaders describe the work they are doing in support of their hospitals during this pandemic – some common themes are being nimble, partnering closely with clinicians, staying focused, ensuring the safety of their onsite staff, being responsive with a can do attitude and providing rapid, innovative solutions. I have great respect for all of them as they navigate and lead during this unprecedented time.

Becker’s Hospital Review published a summary of advice from healthcare leaders last week titled “73 hospital leaders in 10 states hit hardest by COVID-19 offer advice to colleagues: If you do nothing else, at least do this”. Respondents are from New York, New Jersey, Massachusetts, Michigan, California, Pennsylvania, Illinois, Louisiana, Florida and Texas. The responses are organized by theme – I focused first on the leadership, communication and strategy theme. 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 →

Gratitude at a difficult time

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As the weeks of staying at home roll into months, I have nothing to complain about. We can do this. We have to do this. As some of the toughest weeks are yet to come, it is a good time to practice both positivity and gratitude. What I’m grateful for:

A child’s sidewalk art found on recent dog walk.

  • The doctors and nurses on the front line fighting this invisible virus, risking exposure themselves while caring with compassion for their patients.
  • The healthcare staff throughout our hospitals who support those clinicians.
  • The workers at every step of the food supply chain.
  • The truck drivers and delivery drivers moving needed goods.
  • The police and fire departments and other city workers keeping us safe.
  • The health experts who are telling it like it is.
  • The researchers and scientists who are working hard on testing, treatments and a vaccine.
  • The government officials who are leading based on facts and protecting their citizens.
  • The manufacturers who have pivoted to make needed supplies for our hospitals.
  • The health technology companies rolling out solutions for hospitals to manage during this crisis.
  • The journalists who are keeping us informed and searching for truth.
  • The technology and infrastructure that allows us to work from home and stay virtually connected.

And on the personal front, I’m grateful that:

  • I can stay connected virtually with my family and friends
  • I have a daughter who lives close enough to help do grocery delivery, so we only have to go out to walk the dogs and get exercise
  • My soulmate, Tom, and I will celebrate 44 years of marriage this week. I wouldn’t want to be staying at home with anyone else!

The growing number of COVID-19 cases and deaths is truly numbing. It makes us want to turn the news off. But remember that each of them is a person, with a family and a story.

May you find much to be grateful for as together we get through this crisis and do your part to flatten the curve.