COVID-19 Coverage Baptist Health
March 16, 2020

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March 16, 2020: Coronavirus preparedness is the name of the game in healthcare right now and for this quick episode, we are joined by Dr. Brett Oliver from Baptist Health to hear about how they are providing for their community and employees during these trying times. Dr. Oliver stresses their role as a source of trusted information that is so needed at this point and explains the measures that are being taken at Baptist Health in order to keep safe social distancing and put their personnel at least risk. He also comments on how coronavirus can stretch healthcare systems and ways to keep up with the regular amounts of patients and cases that are present on top of the COVID-19 pandemic. Stretched healthcare facilities are one of the biggest threats we are currently facing and managing these concerns remains a priority for many involved. From there we turn to the use of health technology, commenting on e-visits and remote patient monitoring. Dr. Oliver shares his thoughts on chatbots and messaging with patients and inquiries before finishing off offering some ideas on remote work and managing limitations of infrastructure and facilities. 

Key Points From This Episode:

  • Ways in which Baptist Health is providing for the community with trusted information.  
  • Measures for minimizing contact and protecting those on the frontlines.
  • Keeping up with normal workloads of sickness and injury on top of coronavirus. 
  • Measures at Baptist Health in the technology sphere; e-visits and remote patient monitoring.
  • Communication with community; on hold messaging, reminders and chatbots. 
  • Remote work at Baptist Health and the role of the infrastructure team in setting this up.
  • Dr. Oliver’s recommendations to other health systems in process of preparation.

COVID-19 Prep with Baptist Health KY

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COVID-19 Prep with Baptist Health KY

Episoide 199: Transcript – March 16, 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.

[00:00:04] BR: Welcome to This Week in Health It News where we look at the news that will impact health IT. My name is Bill Russell, healthcare, CIO, coach, and creator of This Week in Health IT, a set of podcast videos and collaboration events, dedicated to developing the next generation of health leaders. 

This week, I’m going to do a series of interviews with health system execs who will share their plans for COVID-19 preparedness. I want to thank Sirius Computer Solutions who reached out to me last week and asked if they could sponsor a series of conversations to help the industry prepare. I appreciate their foresight and commitment to the industry they serve. 

Our first conversation is with Dr. Brett Oliver with Baptist Health out of Kentucky. Good morning, Brett, and welcome to the show. 

[00:00:43] BO: Good morning, Bill. Thanks for having me. 

[00:00:44] BR: I should say welcome back. You’re a second time guest. Really, thanks for taking the time. I know this is a busy time for everybody and I really appreciate the time. Let’s just get right to it. The first question is pretty general, and it is what is your health system doing in the way of preparedness? This could be clinical or whatever other things you’re doing with the community. 

[00:01:08] BO: Yeah, sure. As far as for the community’s sake, we’re just trying to be that trusted source of information, which we’d sort of were but it’s taking it up a notch. We even launched a separate website page just for that information, which hopefully can be the place where they can – Patients can go in our area or community and know what’s happening from a CDC perspective but then also how we’re handling it and how care changes as you can well imagine the care models are changing to try to keep folks out of some of our facilities if it’s not appropriate. That’s a big transition for folks, a big mind shift in terms of how we’re approaching things but lots of potential technology things if you want to dive into that, but I think as far as we’re just trying to be that trusted source of information for our community, one place that they can go and get real information maybe not from the Twitter sphere. 

[00:01:58] BR: Yeah, and we are going to dive into the health IT. That’s going to be the next area we go. But is the principal essentially this whole social distancing? I mean, we want to have – Clearly, we’re healthcare. We want to have contact with people. We don’t want to have. We will have contact with people but we’re trying to avoid unnecessary contact in the case of exposing people on the front lines to potential outbreak. So their strategies that a lot of health systems we saw a lot of drive-through clinics set up. It sort of creates a waiting room in and of itself, the car which is a self-contained unit. Are there other things like that that you guys are doing?

[00:02:39 BO: Well, I think, yeah, you hit on something that the social distancing is part of it in keeping folks that maybe don’t – They’re not sick enough but could be exposed out of our emergency rooms. But it’s also kind of protecting that surge of the worry well that if you come in with an acute MI or some other very potentially fixable thing that you’re not sitting on a triage because of all the folks that are clogging the system, whether that’s at an urgent care and in office. They get to balance that with – I know our outpatient office visits are down tremendously from folks who are worried about being exposed. So it’s a little bit of a catch-22 from a financial perspective, and hence why we’re trying to ramp up virtual visits and thankful that Kentucky is leading the way in terms of pay parity with telehealth services now. Some of that is being blown out of the water from federal mandates to make sure that that we have access moving forward.

[00:03:29] BR: Yeah, it’s interesting. Actually, we probably won’t talk much about this, but this – Do you start diverting some of the other business, because there is a normal run rate of business of people who are sick and getting surgery and orthopedics and other things? Does this impact all of that?

[00:03:47] BO: Absolutely. As a matter of fact, probably as we’re speaking now, they’ve just finished up. Our senior leadership was having a meeting with the KMA and the governor’s office to see if CDC came out this weekend and talking about delaying elective procedures. Okay, what constitute elective procedures and trying to come up with those definitions that we can all follow, whether it’s so we don’t expose patients, whether it’s because we’re concerned about a surge and not having beds, converting ICUs, and starting operating rooms in the ICUs and things like that. But, yeah, that’s definitely conversation happening as we speak. 

[00:04:19] BR: All right. Let’s transition to health IT. What are some of the things that you guys are doing with regard to the technology and IT best practices? I guess at this point, we’re not – If you weren’t prepared ahead with certain technologies in place, it’s going to be a little late unless you can really spin things up rapidly. But what are some of the things you guys are doing?

[00:04:43] BO: Yeah. We were fortunate in that we were a little bit late to begin with acute video visits or an Epic vendor and through Epic. But I’m thankful that we had that up and running internally over the last year, so that’s obviously a place where we’ve been ramping up, whether it’s the number of providers. We actually also cover Southern Indiana, and you have to have an Indiana license. So making sure some of those credentialing pieces are in place. 

E-visits are a big thing that we focused on. E-visits particularly within Epic are sort of these evidence-based vetted questionnaires of sorts that then present that to a provider in a synchronous way. So we added the travel screens to all the e-visits that we had. We actually created one. We didn’t know if cough – We have one for cough and didn’t know if that one would be so self-evident that you could kind of screen yourself for COVID-19 there, so we created this an additional button. It was essentially the same survey with a couple of tweaks that would lead to that that’s just entitled I think I Might Have COVID-19 and utilizing that. 

The providers that have seen these in our system are just – They’re overwhelming us with great ideas in terms of chronic care follow-up and things that could be done outside of the office now that we can be reimbursed for that. That’s a piece of it and some of that stuff we’re just doing for free. But I can see that continue to ramp up and pushing other projects to the side. 

As an aside, Bill, I think that’s something that we’re realizing that this is sort of unprecedented territory, and we have another hospital in surrounding sites that we’ve acquired and we’re trying to go live with them in December on all systems IT, and it’s pretty clear that a lot of this is going to potentially bump that or will not weigh off. 

[00:06:30] BR: Well, yeah. That’s – So a couple areas I want to go down with you the EHR. Have you created – I mean, clearly, you’re creating some screens. You’re creating some special workflows and whatnot for this. Is there a lot – Is there like a dashboard now or have you – Is your team pretty much fully engaged in this, and what kind of screens and things are they are creating?

[00:06:53] BO: Yeah, that’s great. We placed an – We’re still [inaudible 00:06:57] storyboard within Epic for those Epic folks that are out there. So we still have the traditional banner across the top. It’s for identifying those COVID positive, as well as the test is pending for the COVID patients, so just an additional awareness to staff caring for those folks. 

It’s interesting the analytics sort of dashboard piece. I think the last week or two we’ve been so scrambling for supplies. The supply chain piece and what are we going to do with staffing has sort of dominated our conversations that some of the analytics got pushed off to the side. Really, this weekend, I was asking our team to create an executive dashboard where we could be monitoring some things we already do in terms of bed occupancy. But I’m not sure if we have it broken down into ventilator percentage use, providers that are ill, staff that are ill not necessarily with COVID but that are being quarantined. So try to put that in one place, because if we get the surge that some of the areas have seen throughout the world, we’re not going to have time to build that and I think some of that data will be helpful in managing that operationally. 

[00:07:59] BR: Talk to me about communication, communication with the community. You talked a little about this earlier that you set up a page. I know some systems have done chatbots and other things to help people self-diagnose. What kind of things are you guys doing?

[00:08:13] BO: Yeah. Besides the webpage, we’ve changed all of our own on-hold messaging, some of the patient reminders that go out automatically. We’ve got different messaging there. We are investigating some chatbots. There are some great companies out there that are providing these things now essentially with little to no integration and just point to their site to help triage things. We have not implemented any of that, but that’s definitely on the radar. 

Back to one technology piece that I think is kind of unique and maybe expanding real quick, Bill, if I could, remote patient monitoring. We have some pilots going on to try to reduce readmissions for CHF and COPD, but I can see us easily using that for a moderately ill person maybe with some comorbidities that typically you might bring into the hospital to be able to send them home with the device and using our care managers to monitor as well. 

[00:09:03] BR: Talk to me about this. We’re essentially asking people to self-quarantine and whatnot. Are we able to monitor those people who have self-quarantined or have you thought through that or is that something you guys are talking about?

[00:09:16] BO: We created a document that outlines some the CDC recommendations and then we’ve added to it in terms of what to be looking for if you’re self-quarantining that things aren’t going well. But, yeah, that’s why we’re looking at this remote patient monitoring device to say, “Hey! You know what? This is not the way we had originally intended on using these devices. But what if we could send people home almost to a mini home hospital?” I know folks across the country have been doing similar things but to allow a care manager. This particular product that allows us to see six or seven different data points, as well as a video chat with the patient if need there without having any kind of integration. 

[00:09:55] BR: Second to the last question. I know I’m going to go over and I appreciate your time. But it’s around people. So we’ve been told about remote work and those kind of things, and a lot of IT staff can work remotely. But I think what I’m hearing from CIOs from conversations last week is they had to actually look at it and go, “Hey! Not everybody can work from home.” So have you guys done that planning of who can work for remotely and being able to set them up, and what kind of technologies come into play as to determining whether they can or can’t?

[00:10:28] BO: Yeah. That’s definitely where our infrastructure team. We have to lean heavily on them, because to your point while everyone could work at home, not everyone can work at home from an infrastructure on the network standpoint. Then there’s the typical HR pieces where it’s still up to the manager over that staff, whether or not they have the capabilities of working from home, although this is a unique territory.

I know we’ve ordered a bunch of Meraki devices and then trying to do a lot of things to offload the network as much as possible. We’ve not gone into the point that I’m aware of where we’re rotating people through shifts from things like that to take it off the network. But early on, three or four weeks ago, the conversation was we can’t have all of our system services, corporate folks, IT department working from home and still maintain the network. 

I’ll be honest, I have not been privy to some of those more technical pieces in the infrastructure team, but I know that’s – I just got an email late this morning about that as well. 

[00:11:23] BR: Yeah. You guys have a good separation of duties there, and I’ve sort of eked over into somebody else’s area. 

[00:11:29] BO: [inaudible 00:11:29]. 

[00:11:33] BR: Just closing question which is what’s one thing you would say to a health system that maybe at the early stages of preparation for this?

[00:11:40] BO: I think really it’s outside of technology and it’s probably age-old, but make sure your communication pathways are clear that you’re not having to communicate 10 times, because 10 times is better than none. It may be too late to outline those, but knowing that my team is working on this dashboard and we don’t have somebody over in decision support working on the same thing, because we need everybody’s hands on deck. 

[00:12:05] BR: Yeah, and I appreciate that. Brett, thanks for taking the time. I really appreciate you coming on the show with such short notice as well. 

[00:12:15] BO: No problem, Bill. I appreciate what you’re doing. 

[00:12:18] BR: Thanks. Special thanks to our sponsors; VMware, Starbridge Advisors, Galen Healthcare, Health Lyrics, and Pro Talent Advisors for choosing to invest in developing the next generation of health leaders. If you want to check out more these shows, I’m going to be dropping a bunch of them this week. Hit the website. They will be under a COVID preparedness type banner. So I’ll try to talk to as many health systems as I can this week. If you’re a health system that’s listening to this right now and would like to share with the industry if you think the industry would benefit from what you guys are doing, I would love to have a conversation with you. So please reach out, [email protected] Thanks for listening. That’s all for now.


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