Ochsner This Week in Health IT
April 3, 2020

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April 1, 2020: In times of crisis and great uncertainty, how do leaders in healthcare successfully lead their teams? As the corona virus spreads, more healthcare systems are overwhelmed and healthcare workers are at increased risk, how do we prepare and systematize structures to better support patients and their loved ones, our colleagues, and our community? Every healthcare organization may be run a little differently, but we are almost all in the same boat when it comes to the corona virus pandemic. In this boat too, is today’s guest, Steve LeBlond, CTO for Ochsner Health in New Orleans. Steve is leading his team at Ochsner Health through the COVID-19 crisis in exceptional, innovative ways. Steve has many lessons and valuable advice to share about his experience thus far in leading a team through this unique, challenging crisis. We hear how Ochsner is approaching its containment strategy, building in-house testing capabilities, ICU beds, and daycare centers, hosting patient visitations via Skype, managing work schedule rotations, communicating with staff, and much more! By the end of this episode, not only will you have practical steps to help you deal with the reality of this crisis, but you will also be motivated and inspired to be the leader you need to be.

Key Points from This Episode:

  • Find out what Ochsner is doing to better serve their community during this crisis.
  • The four different pillars that Ochsner is currently working on as an organization.
  • Expanding containment strategies, testing capabilities, and overall care.
  • Find out why Ochsner has set up a daycare center for the children of employees.
  • Supporting 4000 teleworkers who are working in an office one day and at home the next.
  • Learn more about the process of setting up in-house testing and 50 new ICU beds.
  • Communication structure: How to ensure you eliminate confusion during a crisis.
  • Preparing for a surge in confirmed corona virus cases among your workforce.
  • How to keep an engaged workforce that is still willing to be on the frontline.
  • Scheduling your team: If someone goes down, someone else needs to be coming in.
  • Keeping your health IT staff safe by dividing them into onsite work and virtual work.
  • How to approach and expand your telehealth with virtual patient visits for loved ones.
  • The importance of getting creative and resourceful with your solutions.
  • Why Steve drove around for three days finding iPad deals from Best Buy.
  • Latency, bandwidth, data capacity, security: How to handle scaling at a rapid rate.
  • The importance of accepting the “new normal” early on and that this is long-term.
  • What we now know about containment and preparing for care facility capacity.

Field Report: Ochsner CTO Steve LeBlond

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Field Report Ochsner Steve Leblond

Episode 215: Transcript – April 1, 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: Welcome to This Week in Health IT news where we take a look at the news that will impact health IT. This is another field report where we talk to leaders from health systems on the front lines. 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.

As you know, we’ve been producing a lot of shows. It was over the last three weeks and [00:00:30] Sirius healthcare has stepped up to sponsor and support this week in health IT and I want to thank you. Thank them for, giving us the opportunity to, to capture and share the experience, stories and wisdom of the industry during this crisis.

If your system would like to participate in the field reports, it’s really easy. Just shoot me an bill att hisweekinhealthit.com now on to today’s show. All right, sounds good. Today’s conversation is with Steve LeBlond [00:01:00] CTO for Ochsner in New Orleans, out of new Orleans headquarters. Steve, welcome to the show.

Steve Leblond: Thank you very much for having me. 

Bill Russell: Well, I appreciate you taking the time. I know that you guys are extremely busy right now and everybody’s really busy. so I’m just going to get straight to it. I actually, before we, do you give people a little idea of your organization it’s scale scope, reach, those kinds of things. 

Steve Leblond: Sure. Ochsner health, we’re the largest employer and largest health system in [00:01:30] Louisiana about 26,500 employees give or take, you know, a little more than 2,400, you know, physicians and or advanced practitioners. so fairly large health system, large, it shops 650 people, or so maybe not the largest, but fairly good socks.

Bill Russell: Yeah. Give us a, give us a little idea. You guys are starting to surge at this point. I’m looking at all the numbers, all the different States broken down. There’s a great model out on line. I’m using a, and it looks like, you know, New York is, is definitely right in the thick of it. You guys are, you know, are surging right now as well.

It [00:02:00] gives a little context of what your system is doing, around preparation and serving your community. 

Steve Leblond: Yeah, absolutely. You know, we are definitely surging, I think per capita wise, we’re just as bad as, as it gets for the world right now, which is unfortunate. but you know, we basically have four different pillars that we’re working on as an organization, you know, community pillar, expanding, you know, certain things to help our community during this time.

Expanding our ultimate containment strategies, like what are our containment strategies that we have as an organization to contain the [00:02:30] spread of this? How do we expand our testing capable? And then lastly, how do we explain to our, our, our care, the care that we can give? And under each one of those, we have elements that we’re doing.

If you look like our community, cause we’re, we stood up our daycare center, which. We did, I think two or three days, you know, daycare for 1500 employees. Children’s so yeah, no. How do you stand out it quickly? Because as people start losing jobs in the, in the service sector, is that impacts your patients and that impacts you or your employees.

And now all of a sudden, a lot of people might find themselves as a [00:03:00] single income family or, the daycares have shutdown. So how do they, you know, if they’re a single parent, how do they. They get care for their kids. So you’ve got to think of that community level and not just on your normal day to day stuff.

you know, with our containment work, we’ve done a lot of stuff. Obviously a lot of folks became teleworkers overnight. as you can see, I am one I’m I’m here in my home as well. So we, you support 4,000 teleworkers who. Working in the office and on a Friday, they’re all working from home. So how do you do that quickly [00:03:30] and seamlessly for them so they can continue.

You take care of our patients and take care of our organization. Testing’s interesting. We did a lot on testing. you know, one of the things we did, we developed our own in house testing capabilities. So I don’t know if everybody’s doing that. Yeah. But when you’re relying on commercial testing from external places and, or the CDC.

The turnaround time and that can be a several days and they got inundated with that. So we’d done that, set up our own testing. been doing that for about two weeks now, which is great. So we expanded that and then last I’m care, lots of new ICU beds expansion. You know, we stood [00:04:00] up my team and some others, actually stood up 50 new ICU beds in two days.

So that’s impressive to put all that equipment in the rooms, get all that up and running. You know, they’re working around the clock, but, expanded 84 total beds within a week. you know, so all that’s the work that we’ve been doing. 

Bill Russell: It strikes me as you’re sharing those things that, the communication within your organization.

And I was like, it’s really well thought out and that you guys are communicating really well. Can you, can you give us a, I’m already jumping off the questions that I normally would ask, but can you [00:04:30] give us an idea of the communication structure that you guys are are using to make sure that everybody’s informed?

Steve Leblond: Yeah, absolutely. And I think that those are, that aren’t getting hit hard yet. You will need to think this through. I think communication, you know, and the, ultimately it’s the elimination of confusion that you’re after as a leader, the elimination of confusion is going to be key as you go through any crisis.

And so we’ve got, you know, I wouldn’t say over communication, but we’ve got a well-structured daily huddle with every director and above from me it standpoint. So we meet every day in a daily huddle for 30 [00:05:00] minutes to go through our days response. We moved to a seven day a week schedule, to make sure that we provide, you know, support throughout this crisis because Saturdays and Sundays where it.

Yeah, some it folks had that off. Traditionally when you’re in this crisis response, you’re gonna need to work throughout the weekends as well. We have a response center that’s set up. So it’s sort of like your command center, but we call it a response center to coordinate our response. And when you talk about that communication, putting in those contexts, those pillars becomes important for your senior leader, because if you you’re your [00:05:30] individual contributors, you know, they’re gonna be working on lots of different things.

You know, we have a list of a hundred things that all of a sudden new work they’re getting pulled too. And if you can eliminate that confusion and show how that aligns into a greater plan and you’re moving forward and that greater plan, you’re gonna start to suffer from poor morale and you can’t have poor morale with a large team.

as you, go through a crisis, you need to work on that as a leader and work on your communication. 

Bill Russell: Yep, absolutely. So, you know, what’s, what’s one thing you’ve discovered over the past few weeks that might benefit others. I mean, since you are further along in the [00:06:00] surge, you know, what’s, what’s one thing that sort of stands out that you’ve learned.

Steve Leblond: You know, I think, you’re the scheduling, the team is actually important. It might not be the, the, the most interesting the answer, maybe when you go through your interviews, but scheduling your team’s going to be important because as you go through a real surge, these numbers that you see on TV, they’re not just numbers, they’re real people, and those numbers are gonna start to impact your caregivers.

And they’re gonna start to impact your it team. So, what is your plan as a leader, as I T team starts to get [00:06:30] sick because your field techs, your people that are onsite, your asset teams, you know, they cannot not show up to work. They’re healthcare workers first, and as they’re on these floors, and as they may get ill with, with either the Corona virus or any other virus and they go down, what is your plan?

So how do you schedule for that? How do you plan for that? How do you keep an engaged workforce? That’s still willing to be on that front line. So that’s, that’s an interesting thing for me. I don’t know if it’s the most interesting answer that you may have heard from others, but that’s something we spent a lot of time on making sure [00:07:00] that when people do go down, we have someone to come in and you’ve got to keep mine.

This is a longterm thing. So if people think this is a one week, two week thing, it isn’t going to be, this is gonna be two to three months. If you’re lucky with this sort of a staffing plan, and it’s probably gonna be longer than that. So you gotta really think that through. 

Bill Russell: Yeah, I, I, we’re going to have COVID-19 around for awhile.

I, I think the surge, as we’re looking at the numbers search looks like a two, three month kind of thing, and it’s getting people into that mindset. I’ll tell you why. That’s an interesting answer. Cause it’s not one I’ve heard before and we’ve done [00:07:30] a fair number of interviews at this point, but the scheduling is, is, is really interesting to me.

And then, one of the things, and I guess I should’ve thought about this and maybe if I was in the chair, I would’ve thought about this. it’s keeping health, it, people safe. Now we’re in the business of helping the caregivers stay safe and I’ve heard people, you know, putting iPads in the room so that caregivers can actually take care of patients without going in as often.

And those kinds of things. But I hadn’t really thought about keeping the health, it workers safe. [00:08:00] Are, are, is there like training around that or are we, how is, how is that being done? 

Steve Leblond: Well, you know, at Ochsner, everybody gets trained on their origin. Patient. and when this crisis broke out, we sent out and retrain to everybody as well.

So everybody’s got training on PP and then every it staff, you know, we divided our it staff into two onsite and virtual. Now, we have, you know, onsite, we probably have a hundred or so folks virtually. So 550, and all the onsite folks have like masks and make sure they all have a mask. So when they need [00:08:30] one and to use proper PPE, when they go into row, our solution is, you know, you got to keep my, like, you know, we’re healthcare workers first, and that’s what everybody knows.

And we’re not going to impact negatively impact the care of a patient because somebody is like afraid to go in the room. We have the right tools. We have the right equipment. Protect our it staff. And we’re going to do that. However, when people do get it and when they do get ill, whether from a work exposure or from, you know, general community exposure, you know, what is your plan on that?

Because you might, you know, if one person goes it’s easy to back them, but what [00:09:00] happens with four people on a six person team are, are ill and out for two weeks or under quarantine for two weeks leaders plan them. And so for resource standpoint, you gotta make sure you’re still a very effective and yeah.

Your actual ability to solve the it problems with the organization. 

Bill Russell: Yeah, I do. So, you know, w w which one thing that you team has been able to do that, that we would be most impressed with, and I sort of coached you ahead of time to say, you know, everybody’s talking about telehealth and expanding work from home.

Those are really, [00:09:30] so if you want to talk about them, I get it because it’s a, I mean, what we, what we’ve done over the last couple of weeks are amazing, but I I’d love to hear, you know, practically how did how’d you pull some of that stuff off? 

Steve Leblond: No believe it or not, a lot of stuff we had already done a lot of groundwork for.

So when, when 4,000 teleworkers workers go home one day to work, we already had remote connected Tivity capabilities, you know, really good infrastructure, really good bandwidth. We were, you know, lucky at all of those events that we had. No sort of plan the thought about that being on the Gulf coast South, you know, we’re, we’re always ready for [00:10:00] hurricane, so no matter what month it is.

And so you’re always ready to, like, if you have an extended work from home situation, so those were good, but some of the things I think that we did that might be a little bit unique and, or maybe people aren’t thinking about them right off the time, but they’re their, their heads is yet your telehealth solutions are going to expand and they expand.

And I think in a different way, where before, you know, you develop the solution, you put it out there, you can get by it. The opposite suddenly happened like this. Now we have 26,000 people who are coming up with telehealth [00:10:30] solutions and they’re hitting us with them saying, how are you gonna solve this problem, this problem, this problem.

One of the solutions that I thought we did a really good job on was a virtual patient visits. Not for the provider and that’s where most people, no, but for the patient and their family, because when you go into, you know, a crisis situation where it is a pandemic, we’re limiting visitors, right. And you have very ill people in hospitals and not everybody, you know, as ill with COVID-19 you have terminally ill people sometimes in hospitals.

And so what are you doing to enable them to [00:11:00] continue to visit with their families? and so we actually, you know, we went low tech with it a little bit. we went with some old, some older tablets that we had with some Skype accounts, generic Skype accounts, and we bring those to patients. So they can at least do virtual purchase visit with their loved ones.

Because right now we have restricted visitor policy. So you’ve got to think that through and plan that out and come up with a solution that’s somewhat scalable. and it becomes doubly hard because. You know, getting hardware, it can be somewhat challenging for that. I, myself actually drove around and hit all the best buys, shout out to [00:11:30] best buy here in the North shore.

but I picked up 31 best buys, 31 iPads over, three best buys that I hit that we use for some of these use cases. So, you got to get a little creative, especially as you’re spinning these solutions quickly. 

Bill Russell: Yeah. And I heard that from somebody, I didn’t interview the person. I was talking to him on the phone and they said they, they placed a massive order.

For stuff. And they just went down the list until they found something that was in inventory. And that’s what they got. They got a tablet that was available, that they could do this stuff. It’s [00:12:00] amazing, but you’re a CTO. So I’d be remiss if I didn’t ask you about scaling. I mean, we were scaling at a rate.

That normally a CTO would sit back and go, Hey, you know, give me a little time to scale this. I know you put some of this stuff in place, but you still have to, you still have to worry about, latency, bandwidth, capacity within your data center, security and other things. Talk a little bit about, about scaling this out, but how you, how you approach that.

Steve Leblond: Yeah. I mean, you know, we have flexibility already. I think any, any technology leaders, yeah. A [00:12:30] CTO or otherwise, you know, if you’re already at your cap of what you can scale to, like on your regular day, you already have work to do so. If you have a one gig max internet pipe, because your routers are limited or your, when riders limited you, that’s something you need to solve now, not when you, when you’re in the middle of a crisis.

So we were lucky that we have that scalability built in. Now we didn’t have, we have a five gig internet pipe. I’ll probably bore some of your users here when I get, if I start using too technical language, but, you know, a five gig internet pipe, [00:13:00] but we could scale it to 10 gig, you know, and right now, when, when we moved all those folks from home, they only piqued about 40, 50% of our, our preexisting internet bandwidth, but we were able to easily scale up to seven.

So, with regards to like our turnaround times, I would sort of turn around a little bit on both yourself in your customers. Like you need to be. You need to be the it team that your organization needs you to be. And right now we need to be fast. That’s part of it. And so not every project management process that we have in place to manage our work.

Not every normal turnaround time is [00:13:30] acceptable anymore. And that was one of the first things we did is with our asset request process. How do we make it fast? How are we making sure we acknowledge that we received a request within one hour that yes, we have your requests and how do we still get you that hardware quickly, even though it’s a law.

And so you really have to look at your processes and you have to, you know, be flexible with, with what you need and why. you know, if you’re spending two days that make sure you’ve appropriately charged back a device to the appropriate cost center right now, it’s probably not in the best interest of the organization.

You know, I just tell people, charge it at my cost center and we’ll [00:14:00] figure that out after we’re done. So, so I think you do have to move a little quicker than you usually do. And I don’t think you can be an it leader saying, please give me some time. I think you need to look at it and say, how do we move faster?

And that’s where like the seven day a week schedule, it comes into place. That’s where buying hardware. Not hoarding it, but making sure you’re buying the hardware, you know, you’re going to need before, you know exactly what you’re going to need. Like we know we need these cameras on tops of these, these, these computers right here.

so if we don’t know the number we know we need at least need a few hundred by a few hundred while we’re waiting to figure out that [00:14:30] number. 

Bill Russell: All right. Be two weeks ahead. Do you know what’s one thing, the prep process that you wish you had either known or done earlier? 

Steve Leblond: you know, I think, I think knowing how long it would take this would be, I think is probably the, the most important thing I wish I knew because when you know patient one into your state, and I know, I think, I think every state’s past this point, so this might not be very helpful for folks that might see this, but when patient one comes in.

You’re thinking that containment strategies is going to work and this is going to go away. And so we started planning with a [00:15:00] really like a two week, three weeks sort of plan thinking that was going to be sufficient and a week and a half into this when you’re not alone, no longer patient one, but you’re a patient 500 that quickly.

That’s where we realized that this is going to be a new normal for us. And so I think that’s the big thing I wish I’d known because few days our plans were very temporary. Right. They were very temporary, a three week staffing plan as opposed to a three months staffing. Yeah. And so I think that was the one thing that I wish I had a little more, insight into.

[00:15:30] But if you look at how I think frankly, the whole country went, I think that was everybody’s idea was containment was going to hopefully stop this in its tracks. And now I think most people can agree. I don’t think there’s any stopping this in his tracks. This is about, ensuring that, if people get sick, they’re getting sick at a rate where the existing system can still continue to care for them.

And that’s what containment’s really about. I wish I had that perspective going into it. 

Bill Russell: Yeah, it’ll be, I mean, you know what experience is a great teacher and so we will have, [00:16:00] we will have this experience moving forward. but, but it’s hard. Right? I talked to, I talked to Dale Sanders and he was giving me military analogies and he said, you know, you don’t want to scramble your fighters for every, for every CRO that flies by that gets picked up by your radar.

And so we’re going to have this experience and the hard thing is going to be for us to not kick into, you know, full-blown battle mode when it’s, you know, it’s, it’s something that’s really small and manageable because we have this experience. But on the flip side, we’ll have this experience. So we [00:16:30] won’t take these kinds of warnings lightly, I guess, is the way to look at 

Steve Leblond: it.

as, as the next person military, I can appreciate the analogies, you know, and keep your team combat effective and make sure you’re well-resourced and your logistics and your information is flowing, you know, and, all that information. It keeps your morale high and with a, with a fully engaged team, there’s no limit to what they can accomplish.

So keep them engaged, keeping the leader. They need to be 

Bill Russell: Steve. Thanks for your time. I really appreciate it. 

Steve Leblond: Thank you. 

Bill Russell: That’s all for this [00:17:00] show. Special. Thanks to our channel 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 were 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, you can also follow us on social media, you know, subscribe to our YouTube channel. There’s a lot of different ways you can support us, but sharing it with peers the best, please check back often as we will be dropping [00:17:30] many more shows, until we flatten the curve across the country.

Thanks for listening. That’s all for now. 

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