Tag Archives: healthcare

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 →

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.

COVID-19: Health IT collaboration and best practices

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We are an industry that shares best practices and continually learns from one another. As we all deal with uncharted territory, that sharing is needed more than ever before. In conversations with healthcare CIOs it

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

is obvious that the amount of work currently being undertaken by health IT teams is extraordinary.

In that spirit, this week I’m highlighting several resources that might be useful to health IT teams:

Through ThisWeekInHealthIT Bill Russell has produced valuable podcasts for health IT professionals for the past two years, interviewing healthcare executives and IT leaders across the country. Last week he pivoted to focus on COVID-19 with two new services:

COVID-19 Resources is a page dedicated to COVID-19 resources during this time. It’s a resource site for health IT teams when they are asked to stand up a relevant technology or implement a technology enabled process. Visit the page now to see what’s already been shared. And you can help him help others. Just forward any resources for health IT that you are willing to share to Bill at hello@ThisWeekinHealthIT.com

Podcast interviews with health IT leaders on the front lines of the pandemic who are willing to share some of their preparedness challenges, lessons and best practices:

COVID-19 Prep with Baptist Health KY

  • Standing on the lessons of the past
  • Protecting the care providers during COVID-19

COVID-19 Prep with Asante Health OR

  • Establishing communication in crisis
  • Preparedness huddles
  • Prioritization of IT work
  • Leadership skills needed

Continue reading →

Healthcare providers on the front lines of Covid-19

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In my blog last week, I consciously decided to avoid the Covid-19 topic. The situation was evolving day to day and I asked myself what useful insights or comments I could possibly have.

Just 11 days ago, the cancellation of HIMSS20 conference was announced. Many of us were hoping for this as we worried about being in a convention center with 45,000 people from not just around the country but around the world. With the cancellations of major sports, Broadway, closure of Disney, limits on the size of large gatherings, and school closings, the times have changed drastically in a matter of days.

We are being encouraged to practice “social distancing”. People who can are working from home.

But hospitals remain open for business as they must. Our nurses and doctors are on the front lines. IT teams and all the hospital staff who support the clinicians are doing what is necessary to ensure that they can deliver care.

While all healthcare organizations have emergency preparedness plans in place for a variety of incidents, this is uncharted territory that tests the limits of those plans. There will be much to learn and share when we get to the other side of it. But in the spirit of we’re all in this together and the culture of sharing best practices we have in healthcare, here are a few links that might be of value in the days ahead.

UW Medicine CIO’s advice: Prepping IT systems for COVID-19 – by Eric J. Neil published in Health IT News, March 12. UW Medicine was one of the first health systems on the front lines of the pandemic in the U.S. Their insight and advice are invaluable to IT leaders around the country.

While you may question the value of Twitter, it is yet another forum where lessons are being shared from the front lines. Dr. Kira Newman has worked in the ICU in Seattle the past week and posted a 10 part thread:

In one part Dr. Newman provided the link to their Covid-19 Resource Site for other hospitals to use.

17 Coronavirus (Covid-19) Actions for Healthcare CIOs – by John Lynn in Healthcare IT Today, March 11. John is continuing to collect info from IT leaders and will share as he does.

Healthcare IT News is maintaining a list of trusted resources that can be found here: Key resources to keep track of the coronavirus pandemic.

Most of my readers probably work in healthcare organizations and fully understand the magnitude of this pandemic. For those of you who don’t and need some convincing, remember that science and math do matter. Here are two of the best articles I’ve seen:

Why Outbreaks Like Coronavirus Spread Exponentially and How to Flatten the Curve – by Harry Stevens in the Washington Post, March 14.

Coronavirus: Why You Must Act Now – Politicians, Community Leaders and Business Leaders: What Should You Do and When? – Tomas Pueyo, first written March 10 and updated on March 13. The author closed with this message: “This is probably the one time in the last decade that sharing an article might save lives. They need to understand this to avert a catastrophe. The moment to act is now.” So, I share with all of you.

And if working from home is new to you, here’s a good resource to check out:

Work in the time of Corona – a blog by Alice Goldfuss on March 11th.

My paternal grandfather died in the 1918 flu pandemic. He was young but married with three small children. My father and uncle were sent to an orphanage and my grandmother and aunt went to live with friends. Yes, it’s not 1918. Healthcare has advanced significantly. But we are an even more global and mobile society. The most important lesson from 1918 is the impact of social distancing which is shown in this graph:

In closing, I want to express a huge thank you to all who work in healthcare. The strain on our healthcare system is real. The stress on our healthcare workers is real. Let’s all do our part to #SlowTheSpread and #FlattenTheCurve.

HIMSS20 – are you ready?

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If you work in health IT, you know that the annual HIMSS conference is the biggest industry event each year whether you are headed to Orlando in three weeks or not. The number of emails, blog posts, social media posts, and articles providing guidance and recommendations on HIMSS20 grows with each passing day.

In the next two weeks I’m wrapping up my current interim CTO engagement at University of Vermont Health Network and handing off to the new CTO. If like me you are super busy at work, making your game plan for HIMSS20 is probably low on your priority list. With so much info out there, I decided to pull together some resources that might help in your preparation.

Whether you are attending in person or following the happenings from a distance, the Official HIMSS20 Hashtag Guide will help you focus in on your areas of interest. My top picks this year are #WomenInHIT, #HealthcareStartup, #HealthcareInnovation, and #PatientEngagement. And of course, you’ll want to follow all the HIMSS digital influencers. You can follow and engage with them using hashtag #BeTheChange. If you’re looking for who the 2020 social media ambassadors are, the digital influencers have replaced them with a new and more expansive program.

Several recent blog posts are worth checking out for more previews and tips:

With my focus on developing women leaders in health IT, I’m looking forward to the Women in Healthcare and Tech: Closing the Gap to Strategic Leadership session on March 10 from 10:30AM-11:30AM. A panel of trailblazers with backgrounds in healthcare and technology will discuss empowering women and closing the gap to strategic leadership. Continue reading →

Bridging the gap with an interim leader

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My husband and I have both served in interim roles this year. Tom left IT in the mid-1990s to become a Unitarian Universalist minister. He is now a retired minister who does a lot of guest preaching and writing and is very active in our denomination nationally. He did part-time interim ministry at two different churches in our area this year. The first was for 3 months early in the year, and the second was for 4 months this Fall. He was filling in for ministers who were on sabbatical. His role was to preach and lead worship on Sundays, work with the board and staff, and be available as needed for pastoral care.

Compare this to the interim CTO engagement I’ve done since late May. A full-time role keeping infrastructure projects moving forward, helping to ensure a successful Epic go live, dealing with day to day issues, and helping recruit the permanent CTO.

Interim leadership roles take different forms. They range from “keeping the seat warm” to turnaround situations where significant change is needed. Regardless of the role, an interim needs to be able to confidently step into the role, build relationships, gain respect, and get up to speed quickly. Continue reading →