Field Report: St. Luke’s University Health Network

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Bill Russell / Chad Brisendine

St. Luke's University Health Network This Week in Health IT

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May 28, 2020: Welcome to another episode of the Field Report, where we talk to industry leaders about how their health systems are handling the pandemic using health IT. In this episode, we sit down with Chad Brisendine, the CIO for St. Luke’s University Health Network in PA, to see how St. Luke’s has responded to COVID-19 thus far. We discuss how they have integrated virtual care like telehealth into their work model, and how they have been affected by work from home. Chad shares with us St. Luke’s health IT priorities, both currently and post-pandemic, and we talk about how they’re planning on regaining revenue, preparing for another surge of cases, and what Chad considers St. Luke’s greatest lesson thus far. Don’t miss out on this episode of the Field Report!

Key Points From This Episode:

  • Chad explains how St Luke’s has responded to the pandemic thus far.
  • How St Luke’s has integrated virtual care like telehealth into their work model.
  • Chad’s experience of working from home and the changes he has noticed in meetings.
  • Chad mentions Workplace Analytics, a project he is working on with Microsoft currently.
  • Health IT priorities for St. Luke’s now and what Chad predicts they will be post-pandemic.
  • How St. Luke’s is reintroducing the procedures they’re performing, including elective surgery.
  • St. Luke’s preparations for another surge, including PPE and physician’s feedback.
  • What Chad considers St. Luke’s greatest lesson thus far – a squad mentality for ‘solutioning’.

Field Report: St. Luke’s University Health Network

Episode 257: Transcript – May 28, 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.

We have a live episode this week, Friday from 11 to 12 Eastern time. We’re going to talk about funding telehealth’s future with a great panel and your questions. Mari Savakis, CHIME public policies going to really spearhead the conversation. We have Praveen Chopra, CIO for George Washington University. Dr. Stephanie Lahr, CIO, CMIO for Monument Health and Albert Oriol, the CIO for Rady Children’s in San Diego as rounding out the panel. I’m really looking forward to this, I think it’s going to be a phenomenal conversation.

If you’re wondering what the future of telehealth funding’s going to be, you’re going to want to tune in to this and interact with our panel. Mark it on your calendar, invite a friend, let’s make it a party. This Friday, 11 to 12. 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. 

[0:01:21.8] BR: All right, this morning we’re joined by Chad Brisendine, CIO for Saint Lukes University Health Network. Good morning Chad and welcome back to the show!

[0:01:29.3] CB: Good morning Bill, thanks for having me.

[0:01:31.6] BR: It’s always good to catch up with you as I’ve alluded to before, the Saint Lukes is where my parents actually go for their healthcare and my father was actually in the hospital there in the last couple of weeks. He’s doing fine for anyone who is thinking of asking. But his experience was great, I appreciate all the work that you guys are doing. The digital experience is great, the medical record has moved back and forth between California hospitals and a bunch of Epic hospitals, so you guys have done a lot of great work with regard to the EHR and digital and other things. I really appreciate that.

[0:02:11.7] CB: Well thank you Bill and I appreciate you dropping me a note and letting me know about his experience. I sent that to our president of our Anderson facility and he was grateful for you doing that.

[0:02:22.5] BR: Well, yeah. Here’s what I’d love to talk about. So my parents, you know, we had the conversation of what their experience was like during COVID and it’s interesting how people are experiencing this. What I want to start talking about with health leaders like yourself is, what’s it going to look like post-pandemic. I don’t want to get too far ahead of ourselves, I realized there’s still a lot of work to do right now. This is how our podcast goes by the way, the lawnmower comes right by the window, right when we start the podcast.

[0:02:56.1] CB: We’ll probably have a plane land in the backyard over here. I’m sure.

 

[0:03:00.7] BR: Yeah. Not to get too far ahead of ourselves but I do want to start to explore what this is going to look like as we come out of the pandemic. Before we get there, I want to hear from you how you’ve experienced the pandemic thus far, you know? Just give us an idea of what you guys did, how you experienced it?

[0:03:17.8] CB: Yeah sure. As you know Bill, we’re in the eastern PA side, so we’re very close to Jersey, we actually have one facility in Jersey and, as you know, New Jersey, and New York. New York obviously the hardest hit in the country, so we have a lot of traffic come up to one of our hospitals in the Poconos, because it’s a resort area for the folks in New York City so they travel there a lot. We got hit harder there earlier because we have a lot of back and forth New York City traffic. One of our campuses, the Monroe campus, saw the earlier signs of the patients and, really, their volumes peaked out pretty high for us at that one campus. Then we began seeing it kind of migrate down.

As you know, my role is beyond IT, I also have supply chain, radiology, and some other departments. My primary task for the organization was to set up a virtual command center so that was literally, like, early March that we began doing that. Then my second focus was around PPE with the supply chain focus, and one of the things we had was a lot of limitations around our systems. We really needed to do a couple of things.

One is, figure out our search capacity plan, figure out our PPE capability, and then make sure that we’re managing our labor through that process. Those were kind of the roles. We reacted very quickly, we’re able to set up a lot of – we ended up building a lot of custom technology with some of our power apps and low code technology and stuff like that to augment what we had around all that. It was a really nice setup, but we really saw kind of the peak 

We put a bunch of – our strategy department put a bunch of different models together. We are very fortunate that none of those models end up hitting where they were at. We peaked out at about 300 inpatient COVID patients per day, and now we are down to around 100. We saw testing go from 5 to 6 days at the beginning of this to now less than half a day in most of our testing is within a few hours. 

One of the other things we saw around COVID was we have seen some other organizations have higher infection rates among their employees. Ours is less than a half percent. I really think it is a combination of our PPE guidelines that we are able to have. We are able to have the appropriate amount of PPE because I think we are able to source unknown suppliers very quickly, that were external, you know not within our GPO, to be able to get alternative products. 

That is probably more than you wanted to know, but if you have any more additional questions I am more than glad to spend some more time on that, but obviously, very unique situation and you know. 

[0:06:12.3] BR: You have such a unique perspective because you do have supply chain, you do have some service lines, which is kind of interesting. We have talked about that before on the show. We also talked about your low code environment, which I think is really brilliant for other CIO’s to consider. I mean, the ability to configure things and put apps out there very rapidly, so people can go back and listen to some of those shows we’ve talked about those before. But I want to really explore the IT side a little bit.

We saw a huge gains in telehealth, we did a lot of stuff to conserve PPE by using video or whatnot. As you consider some of these things, how do you think those will be integrated in our post-pandemic work models?

[0:07:01.3] CB: Yeah, just a little bit around our virtual care. You know, you probably saw the Microsoft Teams video with St. Luke’s University Health Network. It that was played nationally, and as you know, we’ve had Microsoft partnership for a couple of years, strategic partnership with them. We have done a lot of the foundational work activities around the platform prior to this as redefining our entire communications infrastructure within St. Luke’s. Kind of think of it as the EMR, but redefining communications in a platform like thought process. So what we really saw is an increase obviously in virtual care.

Our primary care physicians and our specialists began leveraging that. What was very unique is, the phone calls were, at the beginning of it, the number one used virtual platform, right? And then, what we began seeing is, it increasing to Microsoft Teams and, you know, we did in our first month 100,000 virtual care visits. 

We were basically doing 75% of what we’d normally see in a practice virtually, which was amazing. I can answer questions – that are obviously a lot of hurdles around that that we experienced, but pretty amazing to see our organization flip that quickly.

[0:08:27.3] BR: Do you think – you know, we talk a little bit prior to this. CMS has sort of stated that we believe this is the future, and we’re going to continue to fund it as such. Typically, the commercial parish follows. If that’s the case, are you guys all in at really transforming from maybe a physical to a virtual for a bunch of this stuff?

[0:08:49.7] CB: I mean, I think the payment model is going to be the key thing for us, if payers will pay, we’ll be all in. If they don’t pay, I think we’re still going to have to be in, the question just isn’t all in or not. And I think that that’s where I kind of go back and forth between, al inl or halfway in, if you want to call it.

[0:09:08.3] BR: This is why I love talking to you, you have business line experience so you think and talk like a CIO should, in terms of really understanding the business aspects of it. You know, how have you experienced work from home at this point? I think we anticipated a significant drop off in productivity but from what I’m hearing, we haven’t really had that. How have you guys experienced it and what are some of the things you guys did?

[0:09:33.7] CB: Yeah, I mean we definitely, obviously – I am sure like most organizations have supported a virtual capability. I mean with the technology that we are using today and other technology similar to it, we’re obviously the Microsoft shop. We’ve been able to really improve communication and collaboration. We used to, and you’ve spend some time with me at St. Luke’s, we would always call up to St. Luke’s 5, and that basically meant we were always 5 minutes late for the meeting. 

Well, that was because we are having to physically go every place. Well, I have been on so many on-time meetings in the company’s history, it is just amazing to see. I know I am getting better at that. Then I’ve really seen a reduction in the timing which people want to spend on a meeting, like 15 minutes. A lot more 15 minute meetings and stuff like, that just a quick pop in or a check in. So I have really seen the communication change. 

I am also working on a project with Microsoft right now. There is a product called Workplace Analytics that we are running right now to look at the pre-COVID, how we worked from a communication and collaboration perspective, to post-COVID. So I hope maybe I can come back and share some of those results with you, because we will all have the data from Teams, Outlook, Tasking, Project, all of it, to kind of look and see how our work transformed during this. I am very interested to see how that’s changed. 

[0:10:55.4] BR: Yeah, I love to do that and so today is May 22nd. I am going to put the date in here, even though we will air it a couple of days later, but the reason I am doing that is because I want to talk about what your priorities are today. I want to make sure that the data is in there. So from a health IT perspective, what do you think your priorities are right now and what they’ll be post-pandemic? 

[0:11:18.3] CB: Yeah, I mean we are just coming off of rolling down our command center, our virtual command center, and also really pulled back on where we’ve got a nice healthy supply of PPE. So we have, what I would consider, stabilized the pandemic if you will and we see the numbers coming down for us and that is just of recent. So now, obviously, I am getting a lot of request like “where is my project?” or “where is this?” or “where is that?” back again. So that started to ramp up.

I think we are going back to all of our projects and we’re really looking at what we keep versus not, but whenever I think about what we are going to be doing over the next 6 to 12 months, if payment – well, with or without payment we are going to continue to optimize virtual care. Depending on how much the payment transitions, I think will depend on the size of investment that we decide to put in it. 

We’ll be putting a business case around virtual care, looking at all of the scenarios, really determining how that is going to change, but we do know – I mean we have already been doing, we always are doing cross reduction strategies within healthcare. I think there is – a pandemic highlights the need to do that even more so. We will continue looking at labor efficiencies and ways to be more efficient at delivering care. I think that this has obviously put in additional lens on that perspective. 

We’ll obviously continue – we have been, and you have helped me do some work around this, continue investing in our digital front door. That work is never done, and we’ll continue to try to make that as efficient and as high – you know my goal with the self-services is: until we get to a 100% self-service rate on every one of our transactions we’re not done. I will probably unfortunately pass away before I ever see that happening.

I am going to keep the energy and the focus on making all of our transactions as easy as possible for our consumers, and making sure that, until every single one of them does it and does it in an efficient easy manner for them, you know we are not done with that work. So that’s probably the 4 or 5 buckets of categories that we have going on within St. Luke’s. 

[0:13:29.3] BR: Wow, well you have a lot going on. You know we are starting to see signs of life, or we are seeing the claims data grow. The Monday claims data is growing and buying across the country and, even in the northeast, it is starting to grow. What kind of things is your health system doing to expand those procedures at your health system at this point, either from a safety standpoint or from a getting the revenue stream back?

[0:13:56.2] CB: Yeah, so we began elective surgeries. It is the 22nd, so I guess two weeks, two full weeks. We are probably back upwards of around 85% of our revenue back, through the month of May where we saw it dip obviously. We took a couple of brutal months, I am sure like many other organizations, but we have seen it start to get back up. So I am very hopeful that we get stuff back up in June. Like in June we see a nice full month of healthy volumes. 

You know what is interesting is, there is a backlog. I mean, you know, people don’t just stop getting sick. They tend to avoid things, and so then the question is really, what impacted people’s health by not taking care of the thing that they have, and how is that impacted them? With or without the benefits covered. So I think what is going to be interesting to follow is, you know this unemployment rate, at whatever it is, 40 million people, what benefits of that impacted people, and then how does that compare to their need to get their health done?

It is going to be very interesting, but I see our surgery backed up. I mean man, we are already on a back log. Think about how big the back log is now. So, there is going to be a lot of volume I think that we have. A pent up demand, I guess is what I will call it. 

[0:15:14.7] BR: Yeah, so how are you planning from a health IT standpoint, to plan for a second surge? I mean you know there is a lot of talk about this. In the fall we might see another surge as we start to open up. Most pandemics actually do have multiple spikes. Are you guys talking about that and planning for that? 

[0:15:36.5] CB: Yes, so I guess I will answer it from a rural perspective. So to me, primary, front-and-center, even though I am the CIO, is making sure that we have appropriate PPE and supplies. So making sure that we have a healthy log of all of that. So that is my primary focus. 

My secondary focus is making sure that we get the physician’s feedback, which we have already done, and began enhancing our virtual care process. So we are already on the path to do. So those are probably my top two things that I see really that needs to occur for the second wave of this. 

[0:16:11.6] BR: Yeah, so what is your greatest learning so far? 

[0:16:15.6] CB: You know what? I really – we implemented a kind of a – and you are probably familiar with a development workbook, kind of a squad mentality for solutioning. We put like pods of people on different types of things. One of the things that I really wanted to do before this was give my other teams the ability to do low code and other types of projects, like the Epic analysts and stuff like that. Teach them how to do – not necessarily build code. Maybe eventually hopefully but get more skilled up into other platforms.

That is probably the one thing that I think that I’ve really enjoyed watching my team do is be willing to pick up all of these additional skills and just jump in. I think coming out of this they are going to have multiple, if you want to call it, technologies on their belt. That is really going to help them, and so that is the positive thing that I think at least the IT team have really picked up on through this. 

[0:17:14.7] BR: Well Chad, I am sort of laughing, because I appreciate you taking the time, but I think I went over so you are probably going to be 5 minutes late for your next meeting. 

[0:17:24.4] CB: Oh that’s all right, well it happens.

[0:17:27.3] BR: Always good to catch up, thanks. 

[0:17:29.8] CB: Yeah, thanks Bill. 

[0:17:31.3] 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, most of you can say this now without me even finishing it, the best way to do that is to share with a peer. 

Stop right now, send them an email, tell somebody, “Hey, this is a great show, I am getting a lot out of it. You’re going to want to check out these interviews and conversations.” The second best way you can do it is you can subscribe to our YouTube channel. We are putting an awful lot of new stuff out there, and it is exciting. The live show will only be available on the YouTube channel. It will not be dropped into the podcast channel. 

Some of you asked me to drop it in last time, but my team here internally wants me to stay focused on the strategy and that is to have content that is specific to YouTube and to start to diversify our channels if you will. So some of that, some of our content will only be available on YouTube. So get over there and subscribe so you know when it is available. 

Please check back often as we are going to continue to drop shows on a daily basis through the end of June, or until we get through this pandemic together. Thanks for listening. That is all for now.