2020 Top 10 Recap – COVID-19 Series

2020 Top 10 Recap – COVID-19 Series

Episode 345: Transcript – December 29, 2020

This transcription is provided by artificial intelligence. We believe in technology but understand that even the smartest robots can sometimes get speech recognition wrong.

[00:00:00] Bill Russell: [00:00:00] Welcome to this week in health IT. This is the second last episode of the year. This is our COVID series recap. If you weren’t around for this, early on in the surge we went to daily episodes where we were talking to health system and hospital leaders about, what they were doing in preparation, how they were handling the work from home, telehealth surge, how they were handling the deployment of new technologies. [00:00:30] Just so many different things happening all at once and we stepped into the gap to share best practices across the industry, as best as we could. And this is a highlight of just some of the more interesting things that were said.

[00:00:45] It’s not really in order of most listened to or those kinds of things. We pulled out 10 clips that were indicative of the kind of wisdom that we were hearing from these leaders. My name is Bill Russell, former healthcare CIO, CIO, coach. Consultant and [00:01:00] creator of this week in health IT. I want to thank Sirius Healthcare who stepped in right around the start of the COVID series and said, Hey, we’d like to support your show and your mission to develop the next generation of health leaders. And it was their weekly support that allowed us to really do those daily shows and then to grow throughout the rest of the year and to add staff and to add services for you. If you don’t know, this is episode like 350, over our three-year periods. So [00:01:30] we’ve been doing this for awhile, and, the sponsors really make this possible. And I want to thank Sirius for that. 

[00:01:36] Also our channel sponsors. If you’re not aware of VMware, our first channel sponsor, StarBridge Advisers. Galen Healthcare, Health Lyrics, Sirius Healthcare, Pro Talent Advisors, HealthNXT McAfee and Hill-Rom. And we appreciate them as well for stepping up. If you want to be a sponsor going into 2021 we are signing people on.

[00:01:56] If you don’t know, we actually end all of our sponsorships on [00:02:00] the year. So we prorate them throughout the year. If somebody comes in in June, they get a six months sponsorship. If they come in at the beginning of the year, they get a 12 months sponsorship. So yeah, we’re going into the new year with the, with a new set of sponsors, although a fair number of these organizations have stepped up to be sponsors again next year to support our mission.

[00:02:19] So we’re excited about that. A couple of things that my marketing team have asked me to make you aware of. We’re doing some new things next year with the show. We have today in health [00:02:30] IT. It’s going to be a daily new podcasts that we are launching. And we look at one news story. Five to seven minutes in length and that’s it. Just one story. So you can, every day, the week we’ll be dropping a new show. You can listen to every day and stay up to date on what’s going on, or you can batch them and listen to them on the weekend and be up to date on five stories that I will talk about. And that’s going to be my show. I’m going to be talking about that.

[00:02:55] We’re taking the Tuesday Newsday show and I’m inviting guests in. [00:03:00] We are going to have six revolving guests throughout the year who come in to talk about the news with me, Drex DeFord is going to continue to do that. Sue Schade has stepped up to do that. we have. Who else do we have? Let me take a look at this. Gosh, well, we have one that we cannot announce yet which is, but we should know soon. And we have Anne Weiler who is a, who has been a guest on the show before. She’s with, she was with Well Pepper as well. Pepper has been sold, [00:03:30] and I’d like to get her perspective on startups and what’s going on in that community.

[00:03:34] And then we have one other guests, which we will be announcing a little later. So we’re going to be doing that back and forth with a couple of people. And then we’re going to continue to do the interviews of industry influencers on Fridays. We’re also going to be going to Monday, Wednesday, and Friday. So Monday is going to be our Newsday episode. Wednesdays going to be our Solution showcase, Friday will be our influencer episodes. So we hope that you will continue to join us and continue [00:04:00] to tell your friends about our show. All right, let’s get to the clips. The first clip comes from the CIO for UCLA health in LA. Obviously we have Dr. Michael Pfeffer. And Michael, I post this question to a lot of the CEOs during the COVID series. And the question was around, preparation for a second surge, which we thought was coming and has now materialized. [00:04:30] And the question was really around what are you doing to prepare?

[00:04:32] And the thing I like about Michael is he’s so articulate. He, and it’s well thought out it’s very logical and, very, again, clearly communicated. So I love this. I love this clip from Michael here, technologies that will I’ll be to respond quicker if there happens to be late a surge.

[00:04:57] Dr. Michael Pfeffer: [00:04:57] Yeah. So I’ll break it into [00:05:00] three areas. So one is analytics. So we built out an incredible amount of analytics. On COVID-19 patient flow, all the things that we need to very closely track how things are going on in our health system and the community as we do all of our testing. So we can see all this information. In fact, the UCLA health COVID testing is actually we have a dashboard that’s public off the UCLA health website, so you can see how many tests we’ve done. We actually had that [00:05:30] in pretty much in the very beginning. But you can see how many patients are currently hospitalized at our facilities and, positive and negative and total testing.

[00:05:39] So it’s actually really interesting. So really robust analytics that are helping us determine where we’re going and then being able to predict the second is our structural kind of design of our electronic health record to enable what we’re, what we call shadow beds. So we can quickly expand the amount of [00:06:00] beds we have in our facilities too, if we need to. So that a lot of work went into building out that infrastructure beyond what we already had. We had some of it in place, but we went really beyond that. And then the third thing is, is, is really about continuing to ramp up our telehealth capabilities.

[00:06:22] One thing we’ve done, which I think is really amazing for our patients is we’ve have inpatient [00:06:30] iPads for basically every patient and on those are not only access to the electronic health record, but also they have a zoom platform and an account assigned to the room so they can actually. A video with their families as well as providers. So providers can actually video into the rooms and allows us to check in. Much more frequently as needed. So all of those technologies in terms of [00:07:00] tele-health and expanding our digital patient experiences is what we’re doing to ensure we’re ready for any future search. 

[00:07:07] Bill Russell: [00:07:07] All right. We go from one academic medical center to another. We go to Michigan Medicine with Dr. Andrew Rosenberg, and I love having Andrew on the show as well because Andrew is a teacher. And because he’s a teacher, he really has thought through a lot of the challenges that we have. And he, he actually caused me to think it caused me. He actually asks me questions [00:07:30] back as the interviewer, which is a lot of fun. And I pose this question about evaluating priorities coming out of a post COVID  world and he immediately turns it to a really a new set of priorities, thinking through a new set of priorities that are aligned with our core and our core mission as a health system. Here’s Dr. Andrew Rosenberg. It’s about a potential second surgeon where we’re going.

[00:07:51] So today’s, I’m going to give the date that we’re recording. This show will probably not go live until next week, [00:08:00] but it’s May 28th. We’re recording the show 2020. How are you thinking about your priorities for health? It, you had a set of priorities coming into the pandemic that were well thought out that had went through governance. A lot of people talked about, and now you have a, maybe not a whole new set of priorities, but you have some things that have popped up as a result of the pandemic. How are you going to prioritize the work? How are you going to evaluate [00:08:30] all the things that are coming at you at this point? 

[00:08:32] Dr. Andrew Rosenberg: [00:08:32] Well, I laughed at that because I think like most people, one of the, one of the tough parts of COVID is that we’re all going through cost cutting. And I’m as much trying to shift that as much as I can to cost optimization type discussions, not just cost cutting. Those tend to be one time. They tend to be disruptive. We tend to get over it. And then yet we haven’t. Really dealt with the underlying issue. So my, my [00:09:00] laugh at your question was that all my priorities before COVID essentially got just completely wiped, clean, and during COVID, and now coming out of it, our priorities are focusing on what really is core to the mission.

[00:09:15] And it’s a tough conversation because most institutions have a lot of trouble really prioritizing all the, what must be done. What’s core versus what’s nice to have it’s. We’re probably is as good and as bad as many other good [00:09:30] institutions. But from my point of view, what it has done is it’s helping me, articulate what really is core to our mission. Just a little bit more. And I’ve mentioned a few of the examples already where we’re duplicating. Where we have three tele-health video platforms, things like that. I’m hoping that this will give us a little bit more clarity to point out what really is core. And we have to focus in on. 

[00:09:58] Bill Russell: [00:09:58] New York city [00:10:00] experienced the really the brunt of the initial surge more so than any other city in the country. And HSS, which is the hospital for special surgery, is in the heart of New York city. And, probably no organization went through as much transformation as they did. Early on. They are an orthopedic hospital. They, that is what they do that is predominantly in re pretty much all that they do. And during the surge, they made the transition [00:10:30] to be a COVID hospital. Right. So they had to redo their Epic implementation. They had to redo, their workflows and a whole bunch of other things. And they did that in this, in this clip, I talked to Jamie Nelson, the CIO for HSS about, about that transformation and what it looked like at their hospitals. So here’s Jamie to talk about that. 

[00:10:53] EHR is pretty significant. So you’re, you’re implementing all new workflows and whatnot. Can you give us some idea of [00:11:00] how you sort of triaged and manage all those builds and all that work? 

[00:11:04] Jamie Nelson: [00:11:04] Well, I’ll tell you, we just looked at the amount of hours that our staff have put on COVID projects in the month of March and it’s 6,000 hours. And we only have 180 people in our IT department. We are, we’re a $2 billion organization with a fairly slim it function. So that’s, that’s an amazing amount of hours. And I will tell you what we learned is to be agile and [00:11:30] flexible. And a lot of the old processes are gone. So for instance, I was in the hospital this past Sunday, doing rounds, and one of our lead physicians looked at me and said, Jamie, we need an Epic to have COVID positive, pending, and negative coded in EHR.

[00:11:46] So we see red, we know what that means, yellow. We know that means green. That means. That’s a Sunday afternoon, Monday afternoon that was gone through our Epic team gods of our clinical [00:12:00] content board, all that necessary. So within 24 hours, those changes were in. Normally our, my COO said that would take two, three weeks. So when I think of that, I think that’s just an excellent example of the rapid speed that we’re working at because. These, these truly are life and death things that we’re doing again, not something that we’re used to in an orthopedic hospital, certainly our colleagues and the general hospitals, especially those with large ICU’s are used to this, [00:12:30] but I don’t think anybody’s used to just eating in those hospitals.

[00:12:33] They’re not used to the pace of change because this virus is different than any clinician has seen it any time. So. Yeah, it’s just a whole different paradigm. And bill, I’m hoping that some of the changes we’re making now in terms of our processes will stick after we’re back to our new normal, because I think there’s a lot of good we can take out of this very. Very difficult situation. 

[00:12:58] Bill Russell: [00:12:58] During the pandemic we saw a [00:13:00] lot of technology get used differently than it was maybe intended or used for the first time. maybe at certain health systems. we had Dr. Ben Kanter the CMIO for Vocera on, and I wanted to really identify with him what, what we’re doing around, these technologies. Especially around the communication platforms. We have a lot of different ways.e communicate. We communicate via text fax. We communicate via email. We communicate a lot of different ways. We communicate. [00:13:30] And I was wondering what we are doing to stay ahead of that curve from a policy standpoint to say, this is the single point of truth for communication within our health system. So I posed that question to Ben Kanter, MD the CMIO for Vocera. Here you go. 

[00:13:46] A lot of policy work that has to be done and how we think about it. And so what I hear you saying also is that. Hands-free communication world will probably become the norm. There’s no reason for it not to become the norm throughout the entire health system.

[00:14:03] [00:14:00] Dr. Ben Kanter: [00:14:03] Yes. And I do believe that things are moving that way. There’s a time and a place to where you have access to your hands, where you have access to a smartphone. There’s a time and a place where you need to be hands free, whether that’s, in an isolation room under PPE or it’s in the, or, or you’re doing a procedure.

[00:14:20] So hands free. And using the voice interface is the way that we’ve become used to in our commercial devices over the past couple of years is, is really the future. [00:14:30] So voice-driven actions are going to be key as far as policies and procedures. It’s an interesting question because over. As smartphones have come into use in the hospitals, there are now more and more ways to reach people, whether it’s by text, voice, SMS, video, et cetera, each of these modes of communication brings with it, advantages and disadvantages.

[00:14:56] So for example, if I’m trying to communicate with you and it’s a large [00:15:00] volume of very highly contextual information, it’s probably best that we have that discussion. Like we’re doing today. Some kind of synchronous communication. If it’s a small short message, that’s not very intricate. Perhaps a text message is appropriate. Some of these message modalities are more interrupted than others. So it’s actually made the communication environment more complicated, not simpler in the old days, I either walked [00:15:30] up to you or I called you. So you do need policies today. You need policies that guide, what are the appropriate uses of certain technologies and inappropriate.

[00:15:39] I’ll also give you one other important example and health systems a problem. See that defines the electronic health record as your gold standard place for all patient documentation. There’s probably 150 different options for secure texting. I mean, I could literally build a secure text [00:16:00] solution if that’s all I want to do, build an isolated, secure texting solution. I could build that my garage in days. Literally I’ve done that. So you need to have a top-down solution that says, look for our enterprise communication and collaboration. Here is the system that we will all be on because if you have your doctors on one system, your nurses on another administration on another respiratory care [00:16:30] on another.

[00:16:31] They’re not truly communicating and they can’t collaborate. So policies regarding communication in general are going to be very important. 

[00:16:39] Bill Russell: [00:16:39] One of the first interviews we did in the COVID series was with Anshul Pande the, CTO for Stanford children’s. And at the time we saw this really growing  and the number of visits for tele-health going up significantly. And since I had a CTO [00:17:00] on the show, I thought, Hey, who better to ask about how we were going to scale this up from a technology perspective, how w how are we going to handle the. the increasing load on our networks, the increasing load on our platforms, if we had a platform in place or even standing up new platforms, if we needed to do that. And, he didn’t disappoint. Here’s Anshul, anshul Pande, the CTO for Stanford Children’s. 

[00:17:24] CTO and you’re, you’re handling you’re focused in on the technology aspect. So let’s talk [00:17:30] about that because I’ve gotten some questions for people on scaling up and those kinds of things. So you did your. your telehealth is increasing in capacity. Now did you factor that in when you sorta provisioned your tele-health to be able to scale to this kind of magnitude, or are you doing a lot more telehealth right now than you were say two months ago? 

[00:17:54] Anshul Pande: [00:17:54] Yeah. So we were scaling up telehealth for the last two years. It was a, it was a gradual ramp up every [00:18:00] year. Target was two to three times what we did the year before, and it has increased about seven to 10 fold in the last two years from a telephone perspective. So it was a gradual ramp up on the other side. In the last week, it has gone up 10 X. Just in terms of the number of visits, it’s a different kind of a ramp up, which requires a different kind of a framework.

[00:18:23] So it’s not just the infrastructure ramping up to support it, but it’s also. How are you going to get the [00:18:30] docs are working from home to get trained on a new way of doing business rapidly. How are you going to support the patients? Who’ve never done tele-health and they make a call to say, Hey, I don’t do X, or I can’t download something.

[00:18:43] Or my video camera is not working. So that framework to support has been an interesting piece besides the technology portions around it. And then working very closely with the technology partners to say, okay, what is the next scale limit? But today we were expecting [00:19:00] about 300 plus visits. And every day, the first call is okay, what’s the next hardware or software that they’re going ahead. And then how do we prepare for it so that we don’t hit it in the middle of the day.

[00:19:12] Bill Russell: [00:19:12] We’re getting to a point now at the end of year three, that we have some recurring guests on this week in health it and Nassar Nizami is the CIO for Jefferson Health. And, w one of my favorite recurring guests, he is a really, really articulate really well thought out in his approach to just about everything that he [00:19:30] does. And what I decided to talk to him about is how we were going to take some of these digital gains we’ve seen through the pandemic. We talk a lot about these silver linings that we’ve seen a lot of positive things happen. We’ve we’ve developed a vaccine in record time and, we’ve started to use a digital tools like, I like chatbots and, in some remote patient monitoring and home tools and those kinds of things.

[00:19:54] And I was curious, how CEO’s, we’re thinking about, [00:20:00] taking some of those gains in banking them and making sure that we don’t go back to square one. but that some of the gains clearly tele-health being the most dramatic, we have a tenfold increase. We don’t want to go. All the way back to zero. And that’s what we’re seeing now. Some of those gains have been lost, but there’s still significant gains. At the time we’re talking to Nassar Nizami, pretty close to the, to the peak of the surge in New York city. And, just asking, all right, what’s, what’s this going to look like post [00:20:30] pandemic? Are we going to see some of these digital games, stay with us moving forward? So here’s Nassar Nizami to talk about that.

[00:20:37] You guys have so many digital initiatives. So you, you aren’t caught flat-footed by any imagination, but you know, the gains in telehealth are pretty amazing digital, remote patients, monitoring chatbots. I mean, there’s so many things that people have put in to combat the pandemic and to improve communication. How do you think [00:21:00] those things. I mean, those things have been accelerated. Do you think those things will be integrated into our post pandemic work models? 

[00:21:08] Nassar Nizami: [00:21:08] I think so. Look, I’m digital is the right word. I think for technology folks on technology leader, I mean, a future is digital. And I am hearing this, not from CIO is, but CFOs and CEOs and everyone. And this is not just here. This is beyond help here. And I think. [00:21:30] Thanks pro are going to now, there are some question marks. And the biggest question Mark, I think, is in the reimbursement model for Ella health business. Right? So obviously. Well insurance with CMS going to roll back some of the rules or they are going to extend and what will be long-term Fisher that’s I think probably the business driver of telehealth, but I think the big event, our silver lining out of this dynamic is [00:22:00] the cultural shift, both on the provider side and the patient side, and the providers who have used were pleasantly surprised.

[00:22:09] By the technology and just the processes and so forth. And obviously the processes that are still evolving, the same thing on the patient side. I mean, initially we saw a large number of technical issues or connections, not working, et cetera, but, or as our patients are using technologies they’re [00:22:30] or coming and finding that it works, technology works, same things to be, can be set with things like zoom.

[00:22:36] We are, we were piloting remote patient monitoring way before COVID, but now they’re the adoption I think, is going to just increase in that same thing is true for online learning. We don’t, I don’t expect to go back to the same levels in any of the areas that I mentioned, telehealth online, learning, remote work, as a matter of fact, We are now considering a pretty [00:23:00] significant number of folks to be perhaps permanently working from home. Right? A lot of changes I think are going to happen. I think we saw an exponential increase. It’s not going to be back to pre COVID levels is going to be somewhere in between. And that there are a number of factors that will decide where we land. 

[00:23:18] Bill Russell: [00:23:18] All right. Before we get back to the clips, just a quick reminder, we are in the middle of our clip notes referral program. And clip notes is our email that comes out 24 hours after each episode. It lets you know, who was on the [00:23:30] show, what was said in summary format, bullet point format and for video clips. Great way, easy way to share those clips with, people on your staff, with others in the industry. A great way to get the conversation started within your team.

[00:23:44] And we did that in Kentucky. Sure. With a lot of feedback that you gave us, and we are getting a lot of positive feedback on that. We’ve had a hundred people sign up since the referral program started. We have are sending out well over 1500 emails a week, with the clip notes [00:24:00] referral program. And we want you to be a part of that. So if you’re not signed up, go to this week, health.com/subscribe or our homepage, click on subscribe, sign up for clip notes today. That’d be great, but we also have this referral program going on. So if you want to get your friends to sign up for each person, you get to as a referral, they put your name, your email address in there as a referral.

[00:24:23] You get, an opportunity to win in a drawing that we’re doing on January 1st, which is [00:24:30] for a, this week in health, it work from home kit. We also have a black moleskin notebook for anyone who gets up to 10 referrals. And we also have for whoever gets the most referrals, the opportunity to come on the news day show and discuss the news, with me and maybe Drex DeFord we’ll see. So that is still going on and we hope that you’ll be a part of that. 

[00:24:51] I met Rob DeMichiei, the former CFO for UPFC at the health catalyst conference a couple of years back. And we did a [00:25:00] conversation on cost based accounting. And I developed a relationship and early on in the pandemic, I really wanted a perspective of what this was doing financially to these health systems. And it was hard. I mean, so Rob and I got on the call, we started, started talking about these things, but we were hedging our bets. This was early on in the pandemic. You had, health systems that were, that were saying, Hey, you shut down our primary source of income. The beds haven’t filled up with [00:25:30] COVID patients. we have empty hospitals and that was a significant financial hit to these health systems. And so at the time we were trying to make sense of it. And Rob, even in this conversation said, bill, we’re going to have to evaluate this information based on what we know today.

[00:25:46] And what we know today is that we’ve had a significant hit to our, to our revenue stream. And that hit in some cases was, 30, 40%, drop, if not more than that for a lot of these health systems. [00:26:00] And, it’s interesting because, what it showed is. How we did decision making during the pandemic. Right. We did it based on the information we know, and we anticipated a certain outcome based on the information we knew at that moment. But then we went to bed. We got up the next day. And we had to reevaluate the information because the information was new almost every day. If not every week, we were looking at new information saying, okay, the equity markets did [00:26:30] come back a lot faster than we thought they were.

[00:26:31] Okay. This the revenue stream came back faster or it came back slower or we’re still missing about four to 5%. and so I include this clip to say, Hey, here’s how we were thinking early on in the pandemic, based on the information we had, this was a significant hit to the bottom line for health systems. So here’s Rob DeMichiei, former CFO for UPMC and I talking about the financial hit to health systems. 

[00:26:58] Right now, or on the, we [00:27:00] have not flattened the curve. So essentially we’re right in the midst of the crisis itself. So the CFO’s role is really as a facilitator. Taking out the roadblocks, making sure that there is the funds available to do the things that you need to do. That’s the role once the curve flattens. And we start to see this then does the role change, or will there be different phases in the role over the next six months? I guess? 

[00:27:27] Rob DeMichiei: [00:27:27] Well, I think so. And I don’t, I mean, [00:27:30] this is probably going to have a rather long period. So even though the curve gets flattened, If anything, that’s just as hopefully right. We’re wanting to extend this so that it isn’t a spike, but it’s a much longer timeframe. So this facilitation role, I think, will go on for six months, nine months until the crisis truly passes. The other thing, there are other impacts. We haven’t talked about the investment portfolios, bill. Many of the large nonprofits have billion dollar [00:28:00] investment portfolios.

[00:28:01] Some of them use them to support and fund operations. So with the equity markets, that’s, that’s going to be years before they recover. So I think what you’re going to see is financial impact. And again, these are paper losses to many of the health systems, but others do use these funds to support operations. Well these large organizations, you’re going to see investment losses in the hundreds of millions of dollars, close to a billion dollars on some of these systems. And you’ll [00:28:30] see those as soon as the first quarter, but certainly for the full year. So that’s been impact ratios, potentially lending arrangements.

[00:28:38] So that can’t be discounted either in terms of the impact. And then also philanthropy. Donors who had significant equity portfolios, their fun, their charitable decision-making will change. We’ll likely to become more conservative. And again, we have many systems that do quite well on [00:29:00] philanthropy, so that’s going to be impacted as well. So I think the CFO role is going to be this way probably for the next six to 12 months. And then really it’s, it’s going to be about actually some retrospective work and thinking about. What could have gone better? What, how could we have reacted? How could we have prepared better as an executive team for, or the next crisis?

[00:29:24] And there will be a next crisis, whether it’s in several years or 10 years or 20 years, but [00:29:30] I guess the way viruses work, these things, they continue to recur. 

[00:29:35] Bill Russell: [00:29:35] We had the opportunity to sit down with Sherri Douville who is a CEO for a tech startup. And we had a lot of conversations with, individual health systems and from time to time, I just, I needed to step back a little bit.

[00:29:50] I needed a break and I wanted to talk about some different topics. Sherri gave me that opportunity and I thought who better to talk to than a sitting CEO of [00:30:00] a, a successful health tech startup about what a female, an aspiring female CEO would want to do today to prepare for that role of if a female was looking and saying, Hey, that’s the role I want in the future?

[00:30:15] What should I be doing today? So I posed that question, to Sherri and here’s her comments. 

[00:30:20] First talk about a woman who’s not a CEO yet. How do you prepare knowing what you know now as the, as a CEO and board member, how do you prepare yourself? [00:30:30] When you’re not as you’re progressing through your career so that you’re, you’re ready to take that, that type of role.

[00:30:38] Sherri Douville: [00:30:38] That’s a great question. And I think that, Really self-awareness is, is really the biggest lever that you have because having daughters, you probably have talked to them about it, or maybe you will talk to them about just getting a lot of mixed messages from a lot of stakeholders or, or people or [00:31:00] institutions, and, and really it’s the clarity of having self-awareness and navigating what I think women leaders face lots of paradoxes. And at some point I got to a point in this journey and I was very fortunate. Like I said, that I brought in the biggest investor to the company is also my mentor but, and we could talk about him. A lot of his name is  a great leader. He’s got 34 at there. See as a Silicon Valley that he’s mentored and has seen a [00:31:30] lot of movies and mentored a lot of people.

[00:31:33] And the thing about innovation is that innovation does not discriminate. And so that’s why he is then very open to mentoring, lots of different people, not just the classic prototype. And so I’d say to your daughter, Just work on understanding herself and understanding what motivates her and what she’s interested in, understanding what drives her understanding sort of her, her own psychology. [00:32:00] And that’s the best place to start when you’re young. 

[00:32:02] Bill Russell: [00:32:02] All right. As we said earlier, New York city was really the heart of the surge, the initial surge, and we had a conversation with CIO for NYU Langone health Nader Mherabi. And, Nader is the kind of leader you want when the pandemic is surging in your market, I love his perspective on this. He essentially said, look, we’ve been here before, let’s apply what we already know and learn [00:32:30] quickly and adapt to those things we don’t know. And he said, we went through hurricane Sandy, we went through nine 11. We’ve gone through crisis before. So, let’s keep our heads in our wits about us. This is going to be a little different. But for the most part, it’s, we’re dealing with a lot of unknowns and, but we’ve done this before. We’ve dealt with unknowns and we know how to do this. And I just, I love, how he approaches this. How he just has a, he had a calming effect on me and I’m sure he had a calming effect [00:33:00] on all those people around him. So here’s a Nader Mherabi, CIO for NYU Langone on dealing with crisis. 

[00:33:07] What’s one thing you discovered in the past few weeks that might bend benefit others that are maybe a couple of weeks behind where you guys were at. 

[00:33:16] Nader Mherabi: [00:33:16] Well, first of all, I may talk about that crisis and emergency. So I know people ask me, well, what did you do? It’s we’ve been fortunately, unfortunately I’ve been through many crisis, including. September [00:33:30] 11 blackouts ,Sandy’s storm and of course this and part of that at our institution, having a good emergency planning since even Sandy and, and before that in place, and that’s a broader institutional plan about the, in case of an emergency.

[00:33:46] What to do. And we plug into that. And then when I think with create a structure, that’s where money is in place to, how do you deal with crisis? Now? We all know, and based on my experience, there’s crisis all different. So you never get the [00:34:00] same crisis again, when people thought. So the question is, how do you set up a structure to deal with the crisis with APIs and be able to, react quickly improvise as different issue arises.

[00:34:12] So this. Crisis, totally different. That what Sandy ,was Sandy wasn’t even an app in, and then you have to deal with Astra math. This is continuing so in such yes, to prepare your staff, to dealing with this an everyday basis. And so it’s a different type of [00:34:30] crisis. So you got to be very nimble and agile as the need changes to be able to deliver the technology services, whether that’s expanding ICU. That’ll help. And then he started things. And the other thing is about really having a view of technology architecture in the way of integrated environment and capability really matters. This is what I chose is either crack or strength, how you architected your technology infrastructure. And [00:35:00] that’s the real test here. But your staff then you’d use structure and your technology capabilities.

[00:35:08] Bill Russell: [00:35:08] All right. To close this out. I want to close out on a positive note and, BJ Moore with Providence health does not disappoint. He closes this out on a positive note in this series. And the question I asked him and, and other CIO’s was about priorities coming out of COVID. And, I just love the way he, he looks at it and says, look, [00:35:30] we’re going to go through this. It’s going to be tough. It’s going to be hard. We’re going to learn a lot of things. but you know, at the end of the day, we are going to be better for it. We’re going to be smarter. We’re going to be, more resilient. it’s a very encouraging and I’d love to leave you guys with this note. 

[00:35:47] There’s going to be just a ton of projects, right? So we had our multi-year plan and you had your multi-year plan, and then there’s going to be a whole host of new projects that come up [00:36:00] about, as a result of this, how are you going to prioritize those and how are you going to knit those together?

[00:36:06] BJ Moore: [00:36:06] Yeah, I think it needs to be a balance. Those long-term plans. I mentioned Epic consolidation getting onto a single EHR. Getting on an Oracle cloud, those are 1824 month investments. We will continue to do those and that won’t change. But when we evaluate new projects, it’s going to be what support these new emerging health delivery, what are technologies [00:36:30] that are going to enable us? If there are, when there is a second wave of COVID that are going to allow us to respond to that. What are things that are going to help us generate revenue in this post COVID world? What are the things that are going to be able to allow us to cut costs and things that have really short paybacks? Right?

[00:36:45] Six, six months is really what we’re looking at. Anything more than six months. We just can’t entertain at this point in time. And so the good news is there’s a ton of. Revenue opportunities. There’s a ton of new [00:37:00] opportunities from a business perspective. So we’ll have a lot of new projects coming our way and it’s what can we handle as a health system from a change perspective, from an it perspective and obviously from a funding perspective, but I feel optimistic. It’s, I think we’ll come out of this stronger even know where it’s things feel pretty low right now. I think we’ll come out of this stronger. 

[00:37:25] Bill Russell: [00:37:25] That’s all for this week. This is the second last time I will be saying that. I’ll say that one [00:37:30] more time. Don’t forget. We have the end of year, top 10 countdown coming up. So you’re going to want to make sure you listen to that. We’re going to be releasing at the same time on social media, the top 10 countdown, each one of the clips, going down to number one. so that’s our last episode of the year before we get to the new year and we start our whole new, programming schedule, which is the daily episodes where we do Today in health IT. All new channel. Looking forward to that Monday, we’re going to do [00:38:00] Newsday, Wednesday we’re going to do a solution showcase and Friday we’re going to continue to do the influence episodes. So, hope you’ll join us for the new year as well. Special thanks to our sponsors. Channel sponsors, VMware, StarBridge Advisors, Galen Healthcare, Hewalth Lyrics, Sirius Healthcare, Pro Talent Advisors, HealthNXT, McAfee and Hill rom for choosing to invest in developing the next generation of health leaders.

[00:38:21] This show is a production of This Week in Health IT. For more great content, check out our website this weekhealth.com or the YouTube channel, which we designed just [00:38:30] for you. Please check back one more episode this year, check back. We want to make sure that you, listen to our top 10 countdown should be a lot of fun. Thanks for listening. That’s all for now.