Health IT, Hospitals

The key IT decisions that helped providers survive April 2020

As Covid-19 cases started escalating last April, providers in hotspot states, like New York, California and Washington, had to quickly pivot their IT plans. These are some of the decisions that five health IT leaders made — aside from expanding telehealth — that helped their health systems survive the first wave of the pandemic and beyond.

In April 2020, the healthcare industry was pushed to the brink.

With Covid-19 cases surging, and little information available about the new coronavirus, providers struggled to stay ahead of the spread. Among the many consequential decisions made during that period were ones related to IT, as the industry rapidly pivoted to digital.

Of course, telehealth loomed large during this first wave of the pandemic, with providers focusing their money and energy on growing existing services and adding new ones.

But that is not all. There were several other IT-related strategies that providers employed in April that held them in good stead as the pandemic escalated, especially those in states seeing the largest spikes in cases. These strategies included shifting to a remote workforce model, installing software to allow for collaboration and setting up IT command centers.

Before examining these IT strategies, let’s look back to the early months of virus spread in the U.S. From Jan. 21 through Feb. 23, 2020, a total of 14 Covid-19 cases were diagnosed in six states. By April 21, the transmission had become widespread with a total of 793,669 confirmed cases across the country.

Hospitals were facing hurdles on multiple fronts, including severe supply shortages, lack of bed capacity and state mandates to pause elective procedures, which directly affected their financial health. The situation was especially challenging in New York, California and Washington, where cases were exploding in April. While Washington and California saw hundreds to thousands of new cases per day during the month, New York was seeing close to 10,000.

During this stressful time, healthcare IT leaders were tasked with engaging digital capabilities to help their organizations manage the public health crisis while keeping their employees safe.

One of the most significant changes that New York City-based Mount Sinai Health System made was to shift IT to a remote workforce model, said Chief Information Officer Kristin Myers, in an email.

“There was a 600% upward surge of employees working remotely which impacted operations,” she said. “The key was effective communications.”

The health system quickly deployed and enabled multiple communication tools that allowed teams to collaborate and make joint decisions.

Similarly, Renton, Washington-based Providence installed collaboration software and standardized communication on Microsoft Teams to enable remote workers to effectively do their jobs and partner with others, said B.J. Moore, the health system’s chief information officer, in an email.

Remote work was one major outcome of the pandemic, and another was a greater emphasis on data, as providers raced to learn as much as possible about the new coronavirus and how to combat it.

“Covid was complex and the data didn’t fit in a simple registry, where we could depend on specific common definitions of characteristics,” said Adam Wilcox, chief analytics officer at University of Washington Medicine, in an email.

The Seattle-based health system established a more flexible data model to be able to address the needs of both frontline clinicians and researchers. Sharing data and the methods being applied to fight the pandemic helped the health system’s staff be more thoughtful, and less reactive, when making decisions, he said.

“I think if any of us knew the scope and duration of Covid, we would have built more robust data systems around it,” Wilcox said. “That first wave was significant, but it didn’t seem like it was going to last as long as it did.”

New York City-based Montefiore Health System was already in the midst of a major IT project when Covid-19 cases escalated last April, said Jack Wolf, the system’s chief information officer. It was rolling out the Epic EHR systemwide and had six hospitals left. Wolf decided to put the bulk of the project on hold and shift focus to the pandemic.

Montefiore Health System first established an IT command center, with remote teams available 24/7 to quickly address bed expansions and clinician needs, Wolf said.

“Team leads were aligned with their operational counterparts to ensure immediate action on requests,” he said. “Matching our IT resources to Montefiore’s operational Covid response teams proved to be an effective approach.”

Further, Montefiore acquired and configured iPads and rolling carts to allow patients to connect with their families. In those early days of the pandemic, visitation was restricted at healthcare facilities to prevent virus spread. This made hospitalization an especially lonely experience for patients, especially those in the intensive care unit.

“We quickly learned that we were not alone, and everyone was taking the same approach,” Wolf said. “We were lucky to have been early in the process.”

While many providers were focused on surviving the challenges of the current moment in April 2020, some were already looking ahead.

Oakland, California-based Kaiser Permanente, for example, made significant changes to its physical and digital environments to manage surges in patient volume, and eventually, surges in requests for Covid-19 vaccine appointments, said Diane Comer, chief information technology officer of the health system, in an email.

“We rapidly expanded our technology infrastructure and equipment to accommodate for larger volumes of use,” Comer said. “We also increased the bandwidth of our digital platforms and augmented workflows at Kaiser Permanente, including scheduling for unprecedented vaccine appointment demand.”

The pandemic certainly led to an explosion of health IT efforts, which has been widely applauded. But some providers regret not undertaking those efforts earlier.

“Before Covid, I wish we would have invested more in our networks, cyber and remote work capabilities,” said Providence’s Moore. “We had an upward climb to shore up these capabilities at the beginning of the pandemic to remain secure and effective, but we did so in record time.”

Photo: sorbetto, Getty Images