Field Report: Rady Children’s

With

Bill Russell / Albert Oriol

Rady Children's This Week in Health IT

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May 27, 2020: For today’s episode of This Week in Health IT, we sit down with Albert Oriol, who is the CIO of Rady Children’s Hospital in San Diego. Rady Children’s Hospital-San Diego is the largest children’s hospital in California and provides services to the San Diego, southern Riverside and Imperial counties. In this episode, Albert gives us his perspective on how the county and Rady have handled the COVID-19 crisis. We discuss remote working arrangements and how they may change the working environment at Rady coming out of the pandemic, and Albert tells us about some of the adjustments that Rady has made to keep staff and employees safe. Albert also shares how Rady works with other health systems and hospitals in the county, and why they are preparing to treat young adults if there is a surge in cases. Finally, we talk about the technological, genealogical, and logistics developments Rady has made during the pandemic, including increased telemedicine. Tune in today!

Key Points From This Episode:

  • Abert’s perceptive on how San Diego and Rady has handled COVID-19.
  • Remote working arrangements for Albert and how Rady has upped video conferencing.
  • How the working environment might change coming out of the pandemic.
  • Adjustments to Rady’s remote working conditions for staff and consultants in the new normal.
  • How Rady works with other health systems in the county.
  • Why and how Rady is preparing to treat young adults if the need arises.
  • Technology developments at Rady, including telemedicine and drive-through testing.

Field Report: Rady Children’s with CIO Albert Oriol

Episode 255: Transcript – May 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 where we amplify great thinking to propel healthcare forward. 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.

Have you missed our live show, it is only available on our YouTube channel? What a fantastic conversation we had with Drex DeFord, David Muntz, Sue Schade around what’s next in health IT. You can view it on our website with our new menu item, appropriately named, Live. Or just jump over to the YouTube channel and while you’re at it, you might as well subscribe to our YouTube channel and click on get notifications to get access to a bunch of content only available on our YouTube channel.

Live will be a new monthly feature only available on YouTube. How many times I say YouTube in that paragraph? Subscribe to YouTube, we’re going to have some great stuff over there. 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. 

[0:01:13.7] BR: Today’s conversation is with Albert Oriol, the CIO for Rady’s Children’s Hospital in San Diego. Good afternoon Albert, how are you doing?

[0:01:23.9] AO: I’m great Bill, thanks for having me here. How are you doing?

[0:01:28.4] BR: I’m doing pretty well. Listen, you are the 36 or 37th interview we’ve done. We usually do two shows a week, we’ve now done one a day for the last four or five weeks. It’s been great to talk to people in your role and just hear the amazing work that’s going on, and are you the – let’s just start there. I mean, give us a little context of what’s going on in San Diego and what’s going on specifically at Rady’s?

[0:01:54.6] AO: I think overall, San Diego, with this kind of crazy novel coronavirus situation that we’re all facing has overall done very well. I think our public health authorities got into this early on and set up all the kind of preventative measures that we’ve seen across the country.

They got – jumped on it early on and said, the California governor, and we have been planning as well. I think all in all the region’s doing great, the San Diego is doing great in terms of containing the threat, if you will, and Rady Children’s is doing fantastic. Both from an IT standpoint but as well from an overall organizational standpoint. It’s been just incredibly uplifting to see how everybody’s pulled together to plan and execute and get ready for something that, fingers crossed, we hope stays at bay but that we’re ready to tackle if and when it shows its teeth.

[0:03:19.0] BR: Yeah, give me an idea of some of the things that you guys did? I notice you’re in the office, did you really ramp up the work from home and the telehealth for a children’s hospital?

[0:03:31.1] AO: Absolutely. When the stay at home order came in San Diego and California, the schools I think announced on March 10th or 13th or something like that, that they were not going to reopen for a while so we put pedal to the metal to ramp up our work form home efforts. We went from having somewhere around 50 to 100 people working remotely at any given time to now having close to 2,000 people that work from home, and on any given day, maybe even 2,500 [inaudible 0:04:30] that are working remotely. I think some of us are taking turns. We work some days from homes, some days here as you would expect. I have members of my team both are – 

My medical and engineering team as well as my end user services team that – the network team that need hands on to continue to provide support because the operations of the institution continue and things break or things need to get installed. They need to be here and I think it’s important for me to spend some time of my working week here to provide the support to do whatever I need.

The other days I work from home. It works great, it’s a good balance. I think we’re going to see an interesting future when everything is said and done, but work from home, tremendously change. I was asking one of my leaders earlier, how are we doing for instance on video conferencing and what he was telling me is that – he just picked a day and happened to pick April Fool’s day last year. We I think did in total of 19,000 minutes of video conferencing. In that same day this year, we did 10 times that. So –

[0:06:18.8] BR: Gosh. You know, I’ve sat in that traffic in San Diego. I mean, do you think the – there’s two questions really here. Do you think the work environment will change coming out of this? That’s probably one question and, you know, I imagine some of your staff is going to be listening to this, so you might want to be careful how you answer. But the other question is, do you think consulting will change coming out of this? Do you think you’ll think differently about consultants maybe working from – working on a project for you from New York or from somewhere else?

[0:06:53.8] AO: Great question, thank you. I think we have had a portion of our work force that’s worked remotely for years and some of that has been because they’ve had live circumstances. As you know, San Diego has a big navy and marine presence, and a significant portion of our staff have spouses in the military, and they move every three years or what not. So we’ve been rather flexible when it’s come down to enabling people to work remotely, understanding that not everything can be done remotely, but we’ve been on that bandwagon early. What I anticipate is that that is something that now will get augmented at some point.

I don’t know to what extent but because we’re having an opportunity or a necessity to stretch what we were doing beyond what we were doing. And we’re seeing what areas actually work well, and continue to work well, what areas are something that we can get by but it is not ideal. So I anticipate we will see adjustment, continued adjustment on that for a while when it gets back down to the new normal. I think it is the same is true with consultants. We have used consultants remotely for a while as well. What I can tell you is when I come to the office, my commute time has been cut in half and that is just priceless. 

[0:08:43.1] BR: Yeah. So give me an idea of how you work with the other health systems. So you are in between Sharp Scripps, UC, Oral down there I mean that is pretty much most of the healthcare in that market. How did you work with them? I assume you work very closely to talk about how the children’s cases are going to be handled and coordinated if that is somewhat – you know I am just curious how you work with those other health systems. 

[0:09:07.9] AO: Yeah absolute. So Rady Children’s is both the safety net and the provider of choice for pediatric care in San Diego, and we take care of over 80% of the kids in the county. So for the most part, that’s traffic comes our way, regardless where the designated trauma center etcetera. So we already do that. We have a number of NICU’s that are embedded inside the adult hospitals in the region. We have a pediatric unit also embedded in the local Sharp Hospital, etcetera. 

So we partner. We like to say we are the Switzerland of pediatrics in San Diego and we work very closely with all of the adult health systems in the region. Now for COVID, as you know, it’s one of those blessings that the pediatric population seems to have been majorly spared. Not that those kids with chronic conditions or some underlying conditions that make them susceptible are not at risk. They certainly are, but for the most part, I think like other viruses, this is not one that is targeting kids. 

What we’re doing is we have planned to be able to extend the age of people that we can care for so that we can take over the younger adults if need be. If the surge presents in the adult hospitals, we’d be able to take on the younger adults here. The reality is right now, like so many other health systems, certainly in San Diego but in other areas of the country, volumes are low 

Because I think everybody is being very responsible in managing the situation, we are not seeing the surge that is being seen in New York and some of the other areas. I just don’t know when that capacity extension would need to be activated just in case, we are ready. 

[0:11:41.6] BR: Yeah. So give us an idea on this. It is This Week in Health IT, I’d be remiss if we didn’t delve into this a little bit. What are some of the things that you did from a technology side that would be – that people would be interested to – or even amazed at how your team has been able to accomplish?

[0:11:58.2] AO: Well I think like so many others – my team, I cannot speak highly enough of them. It is just been an amazing sight to see how everybody just pulled together, and burned the candle on both ends of the stick, to just enable this organization to continue to function. I will tell you, the week after the stay in place – or the week when the stay in place order came through, our volumes just tanked.

It’s been IT to the rescue to some extent, whereby we went from doing maybe a handful of telemedicine visits on a daily basis, we are now doing about 800 visits a day on telemedicine. So we’re – 75% of our ambulatory care right now is being provided through telemedicine. That equates to about 30 to 35% of our normal, what would have been our normal volume. Nonetheless, it has been a saving grace to continue to provide care for kids that need it, right? 

One of the big concerns with this is the necessary care, whether it’s vaccines or whether it’s just monitoring of kids with chronic conditions, or checking to make sure that those who do need to come in rather than waiting for a condition to exacerbate, etcetera, that it gets caught early. That is being – it is continuing to be enabled right? So that’s been brilliant. On the testing side for instance, our genomics institute has stood up a testing, what we call a COVID mass-testing, that is available as a drive-through function. 

That’s something else that we are able to stand up in record time and work through those processes, not only to be able to capture that information but then to make results available to the county. So it has been just short of incredible. As I say, the collaboration across the house, the clinical, the logistics, the IT has been fantastic.

[0:14:55.8] BR: Yeah, that is fantastic and we will have to have you back on the show. The things you guys are doing at Rady’s around genomics is really exciting. I would love to talk about that. San Diego I think is one of those places that there is so much great stuff going on in healthcare. I just love to highlight that stuff. Thanks again for talking the time, I really appreciate you doing that. I love the mask too, by the way. 

[0:15:24.1] AO: Yeah, thank you. Yeah I will try to not go rob a bank now. 

[0:15:27.8] BR: I appreciate it. Take care. 

[0:15:29.5] AO: All right. Thank you Bill, it’s nice talking to you. Thank you for having me. 

[0:15:32.5] 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 with a peer. Send them an email, let them know that you value and you’re getting value out of the show and also, don’t forget to subscribe to our YouTube channel while you’re at it. 

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.