April 29, 2020

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April 27, 2020: To continue our coronavirus field report series we are joined by Kristin Myers who is the Senior Vice President of Technology at Mount Sinai in New York City! Kristin takes us through some updates and perspectives, giving insight into her health center as well as the city as a whole. She emphasizes the difference that has been made by structure, good communication, and the innovative ways that challenges have been approached. It is these things that have helped doctors and the organizations make progress in the face of such challenging times. We discuss the speedy ways that systems have been installed and how much faster everything has worked within the current crunch and limitations. Kristin pays due credit to the people on the frontlines putting in the extra work and effort as well as highlights what this crisis has shown us about what is possible. We finish off our brief chat thinking about preparing for the following stages of the crisis and what may come after this current phase. For all of that, join Bill and Kristin for this field report!

Key Points From This Episode:

  • An update from Kristin on the state of things in New York City currently. 
  • The importance of structure, communication and creativity during these times.
  • Getting physicians up to speed on new systems in telehealth.
  • The extent to which telehealth has helped efforts during the crisis.
  • How much faster things have moved in response to the pandemic, due to hard working teams.
  • Preparations for after the surge and considering how New York City might change. 

Field Report: Mount Sinai with Kristin Myers

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Field Report: Mount Sinai with Kristin Myers

Episode 235: 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 news day show next week, we’re going to go live at noon Eastern, 9 AM pacific, we will be live on our YouTube channel with myself, Drex DeFord, Sue Shcade and David Munst 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, 9 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. 




[0:01:25.4] BR: Today’s conversation, it is a returning guest, Kristin Myers, SVP at Mount Sinai in New York City. How are you doing Kristin?


[0:01:37.1] KM: Very well, how are you Bill?


[0:01:39.4] BR: Good, did I mess up any of the intro there?


[0:01:41.7] KM: No.


[0:01:45.1] BR: Kristin Myers is a pretty straightforward name but you never know anymore, I get stuck on these things. Thanks for taking a few minutes, I know you guys are really busy. Let’s just jump right into it, give us a little context, you know, today’s April 22nd and what’s going on in New York City, what are you seeing, how are things going? 


[0:02:10.5] KM: Yeah, I think it’s being a very challenging time in New York City as of this morning, their was around 139,000 COVID cases, just in the city, 14,000 deaths and, you know, Mount Sinai has actually discharged about 3,000 COVID patients and we’ve got about 1,500 patients still in the ICU. You know, while things are getting better but we’re not out of the woods by any stretch.


[0:02:47.6] BR: Yeah, these are really extraordinary times especially in New York City. You know, we talked with Jamie from the hospital, from special surgery and she was describing the environment and things that are going on. It’s This Week in Health IT, we’re going to focus in on that aspect of it. 


What’s one thing that you discovered over the past couple of weeks? You know, that might benefit others or people might be surprised to hear that’s going on, we’re not preparing for a second surge as we start to come out of this. I think similar learnings we have from New York City are going to really benefit other areas.


[0:03:28.4] KM: Yeah, I think the first one is around structure in communication, we have been in emergency command center at the health system level and you know, that meets formally once a day that there are multiple meetings a day and then IT has its own command center that meets once a day and I think that what’s important is really to be able to communicate to all the teams and ensure that you put that structure in place. I think that’s one of the critical ones. I think secondly, from a technology perspective, you know, clearly telehealth is scaled up in 40 to 50 a day, to 4,400 cases. Which is significant, the remote working, we went from 1,000 people doing remote working to 10,000 people being remote working every single day. 


And then the creativity that comes into play when you know, you’re really forced to find solutions very quickly and that’s not a morning side, you know, we had the situation where we were converting non-ICU areas into ICU areas. That had no windows and no glass. We were able to use tablets and cameras and you know, to be able to see what is going on with the patient, what’s going on with the vitals and then et cetera which is really important and you know, we’re protecting our front line providers by being able to come up with these solutions.


[0:05:04.4] BR: Did you say 40 to 4,000 a day in telehealth?


[0:05:08.5] KM: Yes.


[0:05:12.0] BR: I assume your infrastructure’s able to handle that. How did you bring so many physicians up to speed so quickly on that?


[0:05:19.4] KM: Yeah, what we did was we set up a special telehealth command center and you know, we were able to work with the physicians and you know, get them up and running very quickly but we had the underlying infrastructure in place which I think was extremely helpful.


[0:05:37.3] BR: The workflow is there, physicians were – the workflow was there and technology was there, the physicians just had to come up to speed on this kind of stuff, right? Front facing light, how to communicate, how to document, what things they could do over tele health, what things they couldn’t do over tele health, I assume that’s the training they’d have to go on.


[0:06:00.9] KM: Absolutely. And then, you know, we had the command center as backup so if they had any questions concerns, et cetera, we could just you know, have a Zoom call with them or you know, walk them through on telephone, whatever they felt comfortable doing. We had that facility for them.


[0:06:18.5] BR: You know, I’m going to get to the other questions. I’m curious, your thoughts, if you think once the New York population experiences this, and once the clinicians experience this, it will go back from 4,000 to 40 or do you think, where do you think it will fall once this we’re past this? You know, those numbers, do you think they’ll level out?


[0:06:42.8] KM: I can’t imagine it going back to 40. I think that the physicians feel very comfortable with the technology and we’ve got a lot of positive feedback from them. I think that initially, there was probably, you know, some reluctance because we’re used to seeing patients face to face. But now that we’ve used it, I think they definitely feel more comfortable. From the patient perspective, I think that from a safety perspective, they probably feel better at being able to communicate than not to communicate with their physician right now. I think that telehealth is here to stay. 


[0:07:22.6] BR: Yeah, this is going to be interesting. Although my mom has told me because she has experienced her first telehealth visit, she said, “You know, there are times I still want to see my doctor.” And I think we’ll see that coming out of this. What specific solutions have you put in place that you talked about the one, what other solutions have you put in place that either the were necessitated by this or that were necessitated by creativity that was just required? 


[0:07:52.8] KM: Yeah, I definitely think that the Google mask cameras and iPads was [inaudible] in other facilities. I also think expanding telehealth to the inpatient facilities so that you could have consults with cardiologists and other specialists. You know without them having to go into the room or actually be at that specific facility has been great and an extension of what we are doing already in telehealth. 


[0:08:28.2] BR: You know I was talking to another CIO about that and they were talking about that they think that the camera is going to be fixed piece of equipment in all rooms going forward and is that do you think we will see that? 


[0:08:42.4] KM: Yeah, I think that that’s probably where we will ultimately move to do this. 


[0:08:48.0] BR: Yeah because it provides us a lot of flexibility. What is one thing that your team has been able to do that you really the most impressed with at this point? 


[0:08:58.0] KM: I think that the teams have being so committed to the work, that to support many of the frontlines. I think that what I have seen is just the giant leap, quite frankly of work that will take weeks to do potentially like it is overnight or in a few days. I think that when there is a crisis in any health system, you know the boundaries of work and work thtat is going to take such a long time just gets done because people look at the hurdles and say, “You know, we can do it.” 


And I think it can do attitude to really achieve results and turn it around quickly I mean it has been amazing and I really want to thank not only for the frontline providers and that sort of thing but also to all the support teams like technology teams who has done such a tremendous job. 


[0:10:01.6] BR: Yeah and having been to New York and having friends in New York, I’ve been to their apartments and they give me the tour and it’s just funny because they will say this is our basement and it will be like a closet. And friends of ours have moved from places that were in the suburbs and whatnot. 


And I don’t think people recognize how big of a challenge it is — I mean the apartments are not, the living arrangements are not all that big. You are home with your kids, you know the work environment changed so dramatically and then they were being asked to so much over and above that. There is an awful lot of just flexibility and just professionalism to get that much work done. 


[0:10:52.9] KM: Yeah and I think that’s one of the key takeaways is you have to really be an empathetic leader because not only are the team members really focused on trying to get this work done, it would be very long hours, working seven days a week, they have their own challenges in their own personal lives and their own anxieties and then on top of that –[inaudible] of that on an individual basis is so important. Having those touch bases, having the town halls. You know having the regular meetings also and just asking really, “How are you? How are your children?” And you know really empathizing and understanding where they’re at. 


[0:11:46.7] BR: Yeah, it is amazing. So you guys are technically – so you had the original surge April 22nd so you are starting to see come back or come down a little bit but the reality is New Yorkers still live on top of each other. I mean no place is like this. I mean to get to your house you’re going in an elevator. To go to work, you are doing in a public transportation. You know is there any talk about what this looks like after the surge is gone? Are we still too close to the surge to be talking about those things? 


[0:12:29.2] KM: No, I think that we are starting to look at preparations for how do we reopen areas of ambulatory care and what is it going to take even for some of the team members to go back to work. But it is going to be a long [inaudible] and it need to be done in coordination with the city and the state and with federal guidance but you know, it is going to take a while. I think that it is not going to be a short process here in New York City at all. 


[0:13:05.2] BR: No and I really appreciate what you guys are doing. You did break up a little bit there from time to time and I hope we captured enough of it. If we didn’t I might reach back out to you for some more.


[0:13:19.9] KM: No worries. 


[0:13:20.6] BR: A little later. So Kristin thanks again for your time. I really appreciate it. 


[0:13:24.2] KM: Thank you Bill. 




[0:13:26.6] BR: That is all for this week. Special thanks to our sponsors, VMware, StarBridge Advisors, Galen Healthcare, Health Lyrics, Sirius Healthcare and Pro Talent Advisors 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 them 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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