April 27, 2020

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April 27, 2020: For today’s field report we are joined by Patrick Anderson, CIO at City of Hope in Los Angeles. We dive right in and hear about the IT systems that Patrick and his teams are building out at a rapid pace at City of Hope to cope with the pandemic. Patrick tells us about a system for checking the temperature of visitors to the hospital en masse using a flare camera system, and a drive-through COVID testing facility with preregistration on Epic too. We hear about the challenge of shutting down the extensive research facilities at City of Hope, and the benefits that prior remote work arrangements are having in getting teams and researchers set up for Televisits as well as work from home capabilities. Patrick talks about the rapid speed this has all happened in at the cost of long work hours, and which organizations his teams have partnered with to make it all happen. We also find out about all of the IT upgrades that have been placed on hold at City of Hope to make way for ones relevant to the crisis and which of the new remote systems will stay or go once we reach a new normal. Tune in for more.

Key Points From This Episode:

  • IT systems built out at City of Hope since the start of the pandemic.
  • Solving the problem of temperature checking visitors using flare cameras.
  • Building a drive through COVID testing capability with preregistration on Epic. 
  • How the teams rapidly scaled Televisits and work from home capabilities.
  • The challenge of shutting down the extensive research facilities at COH.
  • Running seven days a week, 12 hours a day for 30 days to shut the facilities down.
  • Work from home research facilities and having researchers who were already mobile.
  • Scaling into telehealth with AmWell from a previous focus.
  • Future plans to integrate the AmWell telehealth system with Epic charts.
  • The value of taking time to scale telehealth despite being able to do it quickly.
  • All the platform-based upgrades that are on ice now while the focus is on COVID.
  • Which of the recent changes will remain once we hit a new normal.

Field Report: City of Hope with Patrick Anderson

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Field Report: City of Hope with Patrick Anderson

Episode 234: Transcript – April 27, 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.

[0:00:04.5] BR: Welcome to This Week in Health IT news where we look at the news which will impact health IT. This is another field report where we talk to leaders from health systems and organizations on the front lines. My name is Bill Russell, healthcare CIO coach and creator of This Week in Health IT a set of podcasts, videos and collaboration events dedicated to developing the next generation of health leaders.


Are you ready for this? We’re going to do something a little different for our Tuesday Newsday show next week, we’re going to go live at noon eastern, nine AM pacific, we will be live on our YouTube channel with myself, Drex Deford, Sue Schade and David Munch with StarBridge advisors to discuss the new normal for health IT. With you supplying the questions with live chat, also, you can send in your questions ahead of time at [email protected] I’m so excited to do this and I hope you will join us. Mark your calendar.


Noon eastern, nine AM pacific on April 28th. If you want to send the questions, feel free to do that and you can get to the show by going to thisweekhealth.com/live. This episode and every episode since we started the COVID-19 series have been sponsored by Sirius healthcare.


They reached out to me to see how we might partner during this time and that is how we’ve been able to support producing daily shows. Special thanks to Sirius for supporting the show’s efforts during the crisis. Now, on to today’s show. 


Today’s conversation is with Patrick Anderson, CIO at City of Hope in Los Angeles. Good morning Patrick and welcome to the show.




[0:01:32.1] PA: Good morning Bill, glad to be here.


[0:01:35.5] BR: Is City of Hope – is it specifically in LA or it’s on the outskirts of LA, right? 


[0:01:42.5] PA: It’s more of the east side of Los Angeles in the town called Duarte and we also have a big administrative campus in a nearby city. Next to Duarte on the other side of the freeway. We have two campuses basically and we’re building out the campus in Irvine and Orange County as well.


[0:02:03.0] BR: I saw that announcement, that’s really exciting. I’m looking forward to that being built out, although I’m not in Orange County anymore, I’m in Florida but I know that there was such a great need for cancer treatment in that market. It’s exciting to see that project moving forward.


The thing I love in talking with you is that we get very pragmatic very quickly and what I wanted to do was just hear about some of the things that you and your team at City of Hope have been doing, have stood up since the start of the pandemic?


[0:02:44.7] PA: There’s basically one emergency project after another for IT to jump in and assist with all of the COVID planning and all the operations were – primarily our, some of our initial work, Bill, was around, how are we going to assess the temperature of all of the employees and the patients that are coming in and the visitors to try to identify potential symptomatic COVID patients. 


We tried to use handheld temperature monitoring tools and they were breaking down, they’re just not designed for that type of volume. We did an evaluation with flare cameras and they looked very interesting and we were able to create a workflow at six different entrances to our ambulatory clinics at our hospital to monitor everybody that’s coming in and we were able to identify any patients over with over a hundred degrees’ Fahrenheit temperature and then we are able to isolate them and work with them to determine the appropriate next steps. That was a big deal and getting those up.


[0:03:58.9] BR: That’s really interesting. Help me to understand a little bit more. The flare cameras are like mounted on the wall and monitoring people as they’re walking through?


[0:04:07.9] PA: No, because of some of the state regulations, we couldn’t mount anything so we put them on tripods and then we were monitoring all of the entering traffic. We were able to identify that the patients, visitors, and even the employees and segregate them and then do a manual temperature of them on the end of the tongue and so forth to identify potential issues. 


That was a big success, the nurses loved it and it was terrific. So many other interesting things we’re doing is we built out a drive through COVID testing capability with preregistration and I think our quality officers said, “Man, this is working like butter.” They really love the workflows that we built out in Epic and the ability for us to do the drive through COVID testing and we actually built that in a middle of a parking lot and we were able to extend connectivity out there with our infrastructure group and then our applications team were able to make some emergency changes to Epic and bring that online pretty well. 


That was just a marvelous work between clinical leadership, our applications group and our infrastructure.


[0:05:28.0] BR: Yeah, that’s fantastic. I assume the network, was that done wirelessly or did you have something more permanent in place.


[0:05:38.8] PA: Yeah, we created a wireless capability out there with some devices that – we had to run power out there and we’re actually we’re able to run the power, we were able to bring us some wireless devices and connect to our enterprise wireless infrastructure.


[0:05:55.9] BR: Did you end up having the medical record out there, did you have access to the medical record or did you not? You did?


[0:06:02.4] PA: Yes.


[0:06:04.5] BR: Fantastic. I assume that everybody – I appreciate you not starting these two things that everybody’s talking about them but I’m curious how you guys did work from home, telemedicine. Talk a little bit about those initiatives and how you stood them up pretty rapidly?


[0:06:21.7] PA: You know, that was a massive effort. We literally shut down dozens and dozens of buildings. We have pretty expensive research capabilities in the City of Hope and to shut down and reduced laboratory across dozens and dozens of buildings and thousands and thousands of employees, it was very challenging. We had to set up multiple genius bars, we had to work with human resources and all of their partners and literally go across the enterprise and prioritize who is going to be moving off campus and how are we going to do that with education and guidelines and so forth.


We ran these genius bars around the clock, Dell is a strategic partner of ours, we were able to obtain hundreds and hundreds of laptops and we were able to move a lot of people home that were mobile and with that, over a four week period, we moved over 3,000 people home and shut down most of the campus that was not patient placement.


It was very exciting, we ran seven days a week, 12 hours a day for 30 days and we’re able to accomplish it, it was quite a feat.


[0:07:42.6] BR: I appreciated your email I sent you earlier. Hey Patrick, any chance you can go on the show, you’re like, “I’m a little busy right now.” I was like, “Yeah, I guess you were.” Talk about telemedicine and you know what’s interesting about your work from home is, you really moved a research facility into a work from home environment. So that is a little distinct from what we’ve heard from some of the other guests and you know are there special, I don’t know applications, special workflow or those kind of things for standing up research being done at home? 


[0:08:19.6] PA: You know our researchers already work on an international basis Bill. They work around the world, around the clock and they are constantly on the road. You know we are constantly supporting our research leadership and our researchers at conferences and doing collaborative work all around the world. So they were already very mobile. It was really following the research leadership and the work they wanted to do to slow down or even shut down some laboratories. 


Many laboratories still could not be shut down and obviously they’re also shifting a lot of work on COVID research and vaccine development. We do a lot of drug development here at City of Hope as well. So it was literally a shift of priorities as well as helping and ensuring that we follow that research leadership cap on making sure everything can continue with a partial on campus, off campus workforce.


[0:09:25.1] BR: Wow. Talk a little bit about telemedicine. So I assume you stood that up and where do you come from and where did you end up at the peak? 


[0:09:36.0] PA: At the beginning of this COVID process or event, we were – by the way our standards as American Well, they’re a partner with us and that is our telehealth, telemedicine platform. We were basically doing second opinions and helping the large employers with their patients and their families going through cancer situations. We weren’t really doing telehealth yet directly with our own patients and so forth but once this hit and obviously we want to have our physicians work from home in the ambulatory space and literally have the entire work force try to work from home. 


So we stood up American Well for video and telephonic visits in a matter of a couple of weeks and we are up to an excess of 300 clinic visits a day on the American Well platform. We haven’t done the integration with Epic yet on the charting where a physician has the American Well application and the Epic application side by side so they can chart in and take care of the patient. 


It is literally two sessions but we are working. We’ll probably be another month or two before we have that ran up. So it was really a six to nine month project that we had just started the conceptual work on before COVID hit and then we did – we literally did nine months of that work and stood it up in a matter of three weeks. So it was plenty of pretty phenomenal heroic work. 


[0:11:15.3] BR: So do you think that is going to be the new expectation on health IT the next time we are sitting on a meeting when we’re going, “Yeah that looks like it is probably an 18 month project” somebody is going to say, “Okay do it in three weeks.” 


[0:11:27.0] PA: I hope not Bill because you know, we have been working nights and weekends to make all of these things work and it is a little challenging to work that way. You know we like to do a lot more testing. We like to do a lot more test environment builds and sometimes it is good to aim before you shoot right? So hopefully we can just get back from a systems development perspective, get back to norm but I think the future is definitely going to demand more telehealth and more of other types of virtual work for sure. 


[0:12:04.2] BR: Yeah, I know you are doing a lot of platform work prior to this. I mean your run rate stuff, you were really focusing on platforms and modernizing the infrastructure whatnot. How did that play out during the crisis? 


[0:12:23.2] PA: Well you know nothing is ever delivered fast enough in our world unfortunately. You know we are rebuilding everything. We are upgrading our ERP, we are literally optimizing our Epic across revenue cycle as well as clinical, all new workflows, all new capabilities. Our infrastructure, everything is being upgraded from data center modernization to completing the infrastructure. We were just about ready to launch our voice over IP and roll that out to some of our new buildings. 


We have many, many construction projects happening right now and being able to leverage a lot of that development work is good but literally had to shift that all of our priorities, which is very challenging. We are going to continue our pace with many of the large foundational infrastructure projects but again, we are shifting everybody to the COVID work has really slowed everything else down. 


[0:13:26.2] BR: So last question because I know you have to get back and I appreciate your time but how do we come down off this mountain? I mean as you said, working seven days a week. We are doing just incredible things. There is a sense in which you got to the top of the mountain. We should take the group photo, pat each other on the back and say, “Look we got to the top of the mountain,” but at some point we are going to start descending back to a new normal. How do you do that effectively? 


[0:13:53.0] PA: Well I have to tell you Bill, I think that work is going to be different going forward. We are looking maybe reducing how many people come back and maybe allow more and more people to telecommute, maybe full time, maybe share cubicles, to have the managers share offices. You know we are working through all of that right now. Some areas are actually out performing their work prior to COVID because they don’t have to commute and so forth and where we have good KPI’s, I think we have to take a strong look at maybe reinforcing a much more aggressive telecommuting posture within our organization. 


[0:14:37.8] BR: Yeah, well Patrick thanks for your time. By the way, I really like your home office. It is really nice.


[0:14:46.2] PA: I’ll tell you, hunkering down up in Big Bear Lake is a great safe place to be in my cabin up here. So I am very happy to be away from the city but it is still pretty long hours up here at Big Bear. 


[0:15:00.8] BR: Oh I am sure it is but you know I love that cabin feel, I love what is going on. Patrick again, thanks for your time. I really appreciate it. 


[0:15:09.5] PA: Take care Bill, it is good to see you again. 




[0:15:12.3] BR: That is all for this week. Special thanks to our sponsors, VMware, StarBridge Advisers, Galen Healthcare, Health Lyrics, Sirius Healthcare and Pro-Talent Advisers for choosing to invest in developing the next generation of health leaders. If you want to support the fastest growing podcast in the health IT space, the best way to do that is to share it with a peer. Send an email, DM, whatever you do. Go ahead and do that and that would benefit us greatly, we appreciate your support. Please check back often as we continue to drop shows until we get through this pandemic together. 


Thanks for listening. That is all for now.



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