Baptist Health Jacksonville This Week in Health IT
March 19, 2020

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March 18, 2020: This interview continues the series of interviews we are having with health system executives where they share what their plans are for COVID-19 preparedness. Our guest for this conversation is Dr. Stacey Johnston from Jacksonville Baptist Health and she is joining us to shed some light on the collaborative and community-driven regional operation they are running in the five counties of their jurisdiction. We hear about the measures that are being put in place such as a drive-through testing center and telemedicine consultations. Dr. Johnston also sketches out the project from an operations standpoint, talking about how they are managing communications between all the moving pieces and keeping everybody in the loop from one day to another. We also hear about the protocol that they have organized from the moment of testing to assessing the results, informing the patient and finally on to treatment. What Dr. Johnston and her team have managed in terms of quick scaling and getting all willing hands involved is astounding, so tune in to hear the details. 

Key Points From This Episode:

  • Different measures Baptist Health is taking to set up a support community for COVID-19.
  • Daily calls Dr. Johnston participates in with neighboring hospitals, facilities, and physicians.
  • Measures such as a drive-through testing center and telemedicine screenings put in place.
  • A shortage of informatics nurses due to early exposure which Baptist nurses are alleviating.
  • Locations in different counties the testing center will service and how results will be studied.
  • Distributions of teams, volunteers and technologies; how Baptist is processing requests.
  • Daily conference calls and working from home: measures to keep afloat of the operation.
  • How the teams are using and updating screens to keep everybody in the loop.
  • What the situation looks like to coastal communities specifically: post-cruiser self quarantines.

Health IT Coronavirus Prep with Baptist Health, Jacksonville

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Health IT Coronavirus Prep with Baptist Health, Jacksonville

Episode 203: Transcript – March 18, 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.

[0:00:05.0] BR: Welcome to This Week in Health IT news, were we look at the news which will impact health IT. My name is Bill Russell, healthcare CIO coach, creator of This Week in Health IT, a set of podcasts, videos, collaboration events, dedicated to developing next generation of health leaders.

This week, I’m doing, as you know, a series of interviews with health system executives who will share what their plans are for COVID-19 preparedness. If your system has a best practice to share, please shoot me a note, [email protected] and we’ll do a 10 to 15-minute Zoom recording that will hopefully benefit the industry.

I want to thank Sirius Healthcare who reached out to me last week and asked if they could sponsor a series of these conversations to help the industry prepare and I appreciate their foresight in this matter and their commitment to the industry that they serve. Today’s conversation is with Dr. Stacey Johnston of Baptist Health Jacksonville Florida.

[0:00:57.7] BR: Good afternoon Stacey and welcome to the show.

[0:00:59.4] SJ: Thank you so much for having me.

[0:01:01.6] BR: Yeah, thanks for taking the time to meet with us. I know you guys are putting in long hours working diligently to get everything right for the community. I’ll just get right to the questions. The first question’s pretty general and it’s – what is your health system doing from a preparedness standpoint?

What are you putting in place for your community and what kind of things have you been asked to do?

[0:01:24.4] SJ: Sure, we’ve started out having daily calls with our system leaders and that includes physicians, IT, it includes other neighboring hospitals and facilities so that we’re creating a coastal community approach so not just a Baptist organization, involving all of our physicians as well too. On this call, we discuss some of the items that we’re doing as a health system to enable the care for our community and for instance, we are setting up a drive-through testing center.

It’s set to go live starting tomorrow morning, we have our dry run today and with that, we have our ED partners working as the physicians running this program and it will start with a tele medicine visit in order to do the initial screening. Based on the screening, a laboratory test will be ordered for COVID-19. At that time as they meet certain criteria from an epidemiological standpoint, that specimen will be sent to the department of health. 

However, the physician has the capability of ordering the test to be sent to lab core if they do not necessarily meet certain criteria but are still at high risk of having COVID-19 and we are actually – our healthcare IT is helping to collect the specimens. We are having a nursing shortage as we’ve had several nurses go in isolation because of prior exposure and so many of our informaticss have a nursing background.

We have been asked to volunteer and amazingly, all of our informatics nurses have all volunteered to help run the specimen collections through our drive through program utilizing tele medicine as well too.

[0:03:25.6] BR: That’s amazing. Let me ask you two follow on questions that. The first is, the community response to it, because this is an all hands on deck community kind of thing. You’re coordinating with people that you would normally be in competition with, how far does that reach? Is it just within Jacksonville or are you reaching beyond that?

[0:03:49.5] SJ: We’re approaching this as kind of a regional. Southeast Georgia, we will be able to do their testing as well too. Jacksonville Baptist covers five counties and so we will extend into all five of those counties and be the centralized testing center that people can just drive up, get their testing and then go on their merry way and then we’re creating that feedback loop of again, the Department of Health will notify the providers that they get the testing and our ED providers will then do the feedback for those that get sent over to lab core.

[0:04:30.3] BR: How are you keeping up with all that? You know, the federal, the state, you’re in multiple counties, multiple states, they’re relaxing tele health guidelines, they’re relaxing – how are you keeping up with just the onslaught of information that’s coming your way?

[0:04:44.2] SJ: We’re all dividing and conquering. We have our informatics side and our IT side looking at the ONC regulations. We are actually starting to utilize space time for our inpatient providers to the COVID high risk patients as well to – for admissions, that’s one thing we are just now starting to look into. We are expanding our tele medicine capabilities and for our hospital list, our primary care physicians as well as our Age Well center which is our senior center and we are also utilizing – so we talked about tele medicine. 

One thing we’re also doing is we have bought some equipment that will help us capable of doing that testing in house. We’re waiting on FDA approval for the reagents which we expect will come next week and when we have that capability, we’ve built an order in the system already and then once that order is built then we will have to interface it back into our EHR for that again, that closed loop communication of the laboratory results.

We’ve been making changes to the testing and the orderables on the fly, we’ve been doing real life changes in the system and so honestly, we’ve really come together as a system. We have our operational leaders working alongside of technology teams. Again, the informaticss are going and volunteering their time. So it has really come together as a close collaboration. The call that I just got off at 1:00 had approximately 250 people on the call to participate. 

[0:06:30.4] BR: Wow and it is amazing that your people are stepping in. Does that create challenges just knowing who is actually available and who is actually working on what when you’re – I assume the requests just keep coming at a pretty significant pace. How are you managing that info of requests for maybe a new screen, maybe a new analytic, maybe a new – standing up new services in a parking lot and those kinds of things with the changing dynamic of the number of staff you have available?

[0:07:02.4] SJ: So we also have a daily call from information systems leaders. So basically all of the vice-presidents, the managers and directors, we have a call at 5:00 to discuss what the asks were from that day so that we can make sure that we are managing them internally so that I am not promising that the informatics can do something when the CTO maybe is saying that there is something else that we could be doing with our team members. 

So at 5:00 we are coming together to create a standardized communication template of all the asks and what we have accomplished through that day and then anything that we might need to prepare for the next day and then of course looking weeks ahead. For instance, we are working with the organization of how to work from home. So a work from home program and how to support that and that many of our employees are able to VPN in but we did not have enough VPN licensees. 

So we had to expand that, we went from a 500 users to 3,000 users so we could support work from home for an additional 2,500 people. 

[0:08:18.5] BR: That’s also staggering. To scale that quickly is pretty staggering. Let me ask you from a build standpoint, are you building a lot of screens and a lot of things and are there certain dashboards over things that you have had to stand up rather quickly that you think other health systems would benefit from having stood up or being prepared? 

[0:08:45.9] SJ: Yeah, so we are of course are monitoring the data. One thing that we built was the way we built our orderable for COVID-19. We then created a dashboard to see how many people it’s been ordered on. So to have that closed loop communication to make sure all of those labs are followed up appropriately, that has already been built. We’ve also in terms of screens, we have not built any new screens. Although when you log in we are giving an update of what was communicated in that 12:00 call. 

So it’s been asked that we refresh the computers at every shift change just so the nurses are aware of any new updates that are coming from this system because those front facing screens when people log in will be updated every shift. 

[0:09:36.8] BR: This may seem trivial but I am going to ask it anyway, which is coding. How are you handling coding? Because there is a whole new set of codes that just got dumped on this as well, was that easy to set up or just standard practice? 

[0:09:51.9] SJ: So yeah, I mean we are just doing it. We are doing standard practices as best as we can with any of those. We have relaxed some of our change requirements. So typically we have a change freeze and a release date, however we’ve been really relaxing on all of our release dates. We’re basically instead of waiting the week in order to do appropriate testing validation, we are testing validation in the same day that we are releasing any changes. 

[0:10:20.3] BR: Yeah, you know final question. I mean you are in a beach community and you know we have seen the pictures from Fort Lauderdale Beach and other things to that effect, does that create any distinct challenges for you? I mean I am sure there is a whole bunch of spring break people that were either here and traveling through the airport and went out. Does that create any distinct challenges in that environment? 

[0:10:47.0] SJ: Yeah, so we are seeing – you know we also have some cruisers. So that includes our own employees. We’ve had multiple employees that have just recently come back from a cruise but now the CDC guidelines say that anyone returning from a cruise within 14 days has to go home and self-isolate for 14 days. So it is affecting our employees. However, you know, the city has been very adamant about closing down public places, all of our restaurants are closed and so they’ve really been trying to close down the public beaches as well too. 

[0:11:24.6] BR: Absolutely. Well thanks again for taking the time. I really appreciate it and I appreciate all the work that you and your team are doing in the region. Thank you very much. 

[0:11:33.4] SJ: Thank you, take care. 

[END OF INTERVIEW]

[0:11:35.1] BR: That is all for this week. Special thanks to our channel sponsors, VMware, StarBridge Advisers, Galen Healthcare, Health Lyrics and Pro-Talent Advisors for choosing to invest in developing the next generation of health leaders. This show is a production of This Week in Health IT. For more great content, check out the website at thisweekhealth.com or the YouTube channel. If you want to support the show, the best way to do that is to share with a peer however you do that go ahead and do it. Share it with somebody, let them know that you benefit from the show. 

We’re going to be back again with more of these episodes this week and probably into next week if I thought about it. So please check back often. Thanks for listening. That is all for now.

[END]

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