March 5, 2021

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March 5, 2021: City of Hope is a world-class cancer hospital with precision immunotherapy, T-cell and STEM cell medical therapies. CIO Patrick Anderson gives us a glimpse into his role in 2021. What work is top of mind right now? Physical moves to improve access to care are still needed. That’s why City of Hope has expanded into Orange County with huge success. But what about digital access to care? What did remote and virtual care look like during the pandemic in 2020? What are the technology priorities for 2021? From a purely fiscal standpoint some projects have dropped by the wayside. How do you decide which ones to go back to? What will the legacy of the pandemic on health IT be?

Key Points:

  • Throughout the pandemic we had to stop dozens of IT projects and create new ones [00:05:50] 
  • in 2021 we’ve really been able to move the ship from just building and delivering solutions to literally building business value [00:06:20] 
  • What are the silver linings of the pandemic? [00:12:35]
  • People don’t want to go out. They don’t want to go to the hospital or the clinics. [00:16:10] 
  • We need automation everywhere, we need chat bots. We need artificial intelligence. We need prescriptive analytics. We need it all to sustain our growth. [00:19:42] 
  • Frog Parking app 
  • City of Hope 

How Telehealth, Remote Patient Care, and Digital Initiatives are Changing Cancer Care with City of Hope CIO

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How Telehealth, Remote Patient Care, and Digital Initiatives are Changing Cancer Care with City of Hope CIO

Episode 373: Transcript – March 5, 2021

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: [00:00:00] Thanks for joining us on This Week in Health IT influence. My name is Bill Russell, former healthcare CIO for 16 hospital system and creator of This Week in Health IT, a channel dedicated to keeping health IT staff current and engaged. 

[00:00:17]Today Patrick Anderson with City of Hope joins us. He’s the CIO there. And we talk about a lot of things. It’s been almost a year since he’s been on the show. We talked about his playbook. We could talk about KPIs to talk about the impact of [00:00:30] COVID the legacy of COVID on health it and other things. Always a great conversation with Patrick. 

[00:00:35] Special thanks to our influence show sponsors Sirius Healthcare and Health Lyrics for choosing to invest in our mission to develop the next generation of health IT leaders. If you want to be a part of our mission, you can become a show sponsor as well. The first step is to send an email to [email protected]

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[00:01:38] Just a quick note, before we get to our show, we launched a new podcast Today in Health IT. We look at one story every weekday morning and we break it down from a health IT perspective. You can subscribe wherever you listen to podcasts. Apple, Google, Spotify, Stitcher, Overcast. You name it, we’re out there. You can also go to [00:02:00] And now onto today’s show. 

[00:02:01] All right today, we’re joined by Patrick Anderson, the CIO for city of hope. Patrick, welcome back to the show. 

[00:02:08] Patrick Anderson: [00:02:08] Oh, thanks. Good to be here Bill. Haven’t I haven’t seen you in a year or so, so it’s good to see you again. 

[00:02:13] Bill Russell: [00:02:13] Yeah it has been a while you came on during the COVID series and I appreciate you doing that because that was a busy time as well. And you know, since it has been a while, why don’t we do this? Why don’t we start here? Why don’t you give us some background on City [00:02:30] of Hope for our community that may not be familiar with City of Hope? 

[00:02:34] Patrick Anderson: [00:02:34] Sure. City of Hope is a is a cancer center. We’ve been around since 1913. We have advanced therapies in cancer and other chronic diseases. So I’d say we’re half patient care, half research. And what really sets us apart, you know, we’re the founding member of the national cancer NCI the [00:03:00] national cancer Institute. And we’ve been we’ve been collaborating and coordinating with cancer centers around the world for quite a long time.

[00:03:09] We’ve been a best cancer center in US news and world report each year for over a decade or so. We’ve had just tremendous science Bill, tremendous science that leads to these life saving therapies. We’re leaders in hematology. [00:03:30] Those are blood disorders as well as solid tumors.

[00:03:35] We’ve created precision medicine therapies with immunotherapy T-cell and STEM cell type science. We really tailor precision medicine directly to the individual patient. We have good manufacturing plants that manufacture the molecules that we put back into the patients to have their own immune [00:04:00] system fight, fight off the cancer and other chronic diseases. Just tremendous science. 

[00:04:05] Bill Russell: [00:04:05] So you guys are really I mean a research Institute, but you’re also a destination kind of facility. I mean, I assume you have patients coming from all over the country. If not the world. 

[00:04:16] Patrick Anderson: [00:04:16] We do, we’re there. They’re from all over the world. You know, we have a new business called Access Hope and it’s basically where we’re supporting fortune 100 companies, their employees and their [00:04:30] families and they’re all over the world.

[00:04:32] And then we also and we provide second opinions. We work with their prescribing oncologists and and help them make sure they’re getting the best care. And it’s a really a huge growing business for us. The Access Hope for employer groups and employers. We also have international medicine Bill where we we take care of patients all around the world.

[00:04:59] Bill Russell: [00:04:59] What [00:05:00] that? The Access Hope. Was that part of the is that what the Amazon agreement sort of fell into there doing that for employees? 

[00:05:08] Patrick Anderson: [00:05:08] Yeah. Amazon, you know, is one of, one of our customers in there. They’re a tough customer. You have to have pretty advanced cybersecurity to be a supplier to Amazon. Let me tell you, so  it’s been great working with Amazon and, you know they’re fortunate one. So basically a lot of fortune 100 companies followed as well. [00:05:30] It’s been a tremendous success and just our we just beat our forecast off the chart with Access Hope.

[00:05:38] Bill Russell: [00:05:38] That’s awesome. All right. So give us a glimpse into the life of a healthcare CIO in January of 2021. That’s when we’re doing this conversation you know, what work is really top of mind right now? 

[00:05:50] Patrick Anderson: [00:05:50] Well, you know, through the pandemic, we obviously had to stop dozens of IT projects and create new IT projects, [00:06:00] everything from working from home and optimizing all of that to screening employees, screening visitors, to more ICU beds, new workflows, new builds and Epic, just a tremendous amount of work.

[00:06:14] But really, I think what has happened. At least for me as a healthcare CIO in 2021, we’ve really been able to move the ship from just building and delivering solutions to literally building [00:06:30] business value. And I find myself now, Bill and dozens actually, I think the last count was 26 steering committees across the enterprise, as IT is now fundamental to strategy and execution of strategic initiatives.

[00:06:51] So with that being able to drive that alignment across the enterprise, move entities to standards, [00:07:00] lower the cost of it and deliver faster, better, and cheaper requires I think a CIO that is focused on that alignment and focused on on driving those standards. It’s been quite, quite interesting.

[00:07:15] Bill Russell: [00:07:15] So you’re staying busy. Is that what you’re telling me? It sounds like it. So Patrick, last time we spoke city of hope was what was making moves into Orange County. Give us a little background on that work and how’s that going? 

[00:07:29] Patrick Anderson: [00:07:29] Sure. [00:07:30] Orange County is you know, it’s a large County South of Los Angeles County heavy population and a very dense population. It there was, we were just seeing a tremendous amount of patients going from orange County up to Los Angeles County for for care. We really didn’t have a presence there. We have 31 medical centers all across Southern California, a couple of campuses, but people were having to travel [00:08:00] pretty far across Los Angeles from orange County to get that advanced care to get our life saving therapies. So we we decided to invest significantly into Orange County. We’re building a campus in Irvine, but we did open an office in Newport beach and we’re already at capacity there, Bill seeing Orange County patients.

[00:08:23] It’s just been tremendous. So we’ve hired a world-class leadership team [00:08:30] from the best cancer centers across the country to run orange County. We have Dr. Ed Kim from Atrium, and he spent many years at MD Anderson. We’ve hired multiple people from MD Anderson and Houston, and Our president of orange County, you know Annette Walker.

[00:08:49] And she came from Providence St. Joseph. Just a tremendous tremendous leader with tremendous vision. So Orange County is really [00:09:00] underway. Construction is underway for our campus in Irvine. We expect to open doors next year in in Irvine. 

[00:09:10] Bill Russell: [00:09:10] You know, it’s interesting. I was so that’s, that’s physical access to care. And when we’re talking about virtual access and tele-health growth in during the pandemic, it’s interesting. I just saw, and I know you’re doing consults and those kinds of things but the virtual visit aspect. I was reading where [00:09:30] oncologists were not did not feel like the telehealth was a great experience for them during the pandemic. And it’s one of the areas that’s really going back to physical visits a lot quicker. Isn’t it? Is that what you’re finding there or is it a little different? 

[00:09:47] Patrick Anderson: [00:09:47] No we’re embracing virtual care. You know, we were we had already contracted with Amwell before the pandemic. And we were doing the design [00:10:00] work and then the pandemic hit.

[00:10:01] Cause at that point we were doing only about 10 visits a day, pre predominantly international medicine, leveraging other other platforms. But once the pandemic hit, we did an immediate rush on Amwell. We stood it up manually with no integration with our Epic EMR, for scheduling and so forth.

[00:10:25] So it was a little challenging, I think the first couple months. [00:10:30] But once we built in that integration for scheduling where the physicians never had to leave Epic and we were really able to leverage the Amwell platform, we went up to hundreds of visits a day and we’re still at that level.

[00:10:43] And we expect to to stay at that level well into the future Bill. So we’re not. We’re not going to be reducing that. We did see a decline in in ambulatory clinic visits because of the pandemic. [00:11:00] And we now see that slowly recovering, although you know the Los Angeles area has just been hit very hard with the pandemic and so there was a decline in visits but  we’re still keeping the pace with virtual care and we’re expecting the visits to to return this summer back to normal level.

[00:11:22] Bill Russell: [00:11:22] Did you guys have to care for COVID patients or were you more because you’re specialized [00:11:30] didn’t have a lot of COVID patients. 

[00:11:32] Patrick Anderson: [00:11:32] We’ve been taking care of COVID patients since the spring, and we’ve had to expand our ICU with the reverse pressure and all of that. We’ve had to expand that, but, you know, we’re experts in working with patients with compromised immune systems anyways.

[00:11:50] So it was pretty natural for us to take care of COVID patients. It’s just that the patients with the comorbidities and everything is always very challenging but [00:12:00] yes, we’ve we’ve had our we’ve had our surges of COVID patients as well. And it’s been tough. I’ll say it’s been tough.

[00:12:08] Bill Russell: [00:12:08] Yeah. So let’s, let’s talk about the the impact of COVID on the health system. So let’s first start from from a positive side. The, you know, a lot of people have been talking about how you know, the pandemic has been hard, but there’s been silver linings so there’s been a positive movement at the [00:12:30] health system and it, and digital priorities and different things like that.

[00:12:35] What, if any silver linings of you have you found at at city of hope? 

[00:12:39] Patrick Anderson: [00:12:39] Well, some simple ones as the rapid, the rapid embracing of digital health and you know, with the with the virtual care, with the Amwell platform, and then also reprioritizing everything to bring more patient experience roadmaps [00:13:00] forward.

[00:13:00] And that includes more education, more online education, as well as getting our our patient portal more automated around East scheduling. As well as you know each check-in, if you get completely checked in, you don’t even have to stop at reception. And you just go right to the waiting room and then you’re called.

[00:13:25] So bringing those things forward, also the work from home Bill, [00:13:30] we’re probably going to see 70% of my IT team staying home permanently. That’s probably the forecast. I can’t a hundred percent confirm it because we’re still working on the scenarios and the standards and all of that, but a big silver lining in determining the productivity of people at home tweaking their environment.

[00:13:55] Some people are using VPN. Some are not for better performance, but [00:14:00] I’ll have to say that the silver lining in that is less office space and actually higher productivity because people are not commuting on the LA freeway system. And you how that is. 

[00:14:11] Bill Russell: [00:14:11] Yeah. And I’m assuming you’re not in the office or you guys have the nicest offices in the history.

[00:14:18] Patrick Anderson: [00:14:18] Yeah, we are definitely not in the office. My entire team is is working from home, you know, and that’s like over 400 people, so it’s been great. 

[00:14:28] Bill Russell: [00:14:28] That’s fantastic. [00:14:30] What do you think the lasting impact on health IT is going to be as a result of the pandemic? What do you think the legacy of the pandemic on health IT is going to be?

[00:14:41] Patrick Anderson: [00:14:41] You know, I think it’s going to be a continued you know, I think, I think now with the pandemic, we’ve really turned the ship again on providing value. We’ve been able to have to create rapid applications in Salesforce and in other other platforms. Now the business brings us [00:15:00] in faster and an earlier for most strategic initiatives.

[00:15:06] And they also know that everything has to go through governance anymore as well, especially with tighter budgets because of the pandemic. So with that, I think I think what we’re seeing Bill  is a need for it to get in early on all strategic initiatives so that we can contribute our value.

[00:15:25] And that’s really been, I think the most [00:15:30] inspiring result of the pandemic for City of Hope for IT. 

[00:15:36] Bill Russell: [00:15:36] Yeah. Well, I mean, that’s a good segway. What will the technology priorities be for 2021? I realized we’re not through the pandemic yet, but as we sort of progress here and and more and more people get back sedated, but what will the priorities be around technology?

[00:15:58] Patrick Anderson: [00:15:58] No, I think we’re really seeing I’d [00:16:00] focus on on patients experience, but one of the tech items is remote patient monitoring. I think we’re really going to expand that people want to stay home. People don’t want to go out. They do not want to go to the hospital or the clinics. Remote patient monitoring for many, many use cases, you know, we’re We’re also building a hotel on our campus and we’re sort of building out like a subacute type capability there so that when patients are [00:16:30] discharged, but they need to stay close to their, to their physicians, say it’s a bone marrow transplant patient or other types of pretty invasive work.

[00:16:40] We’ll have them at our hotel. There’ll be doing remote patient monitoring at the hotel, similar to what they would be doing at home. And and then being able to connect visiting nurses for doing blood draws and things like that. Yeah. You know, I think we’re going to really focus hard on remote patient [00:17:00] monitoring and increase those use cases and and drive that patient experience.

[00:17:05] Right. And you know, everything from, from wayfinding, for where, you know, we have the frog app now and people are actually able to get an assigned parking spot on our campus before they even arrive, which is the closest spot to their destination on campus. So our mobile platforms combined with the patient experience and automation is really [00:17:30] where we’re focused along with remote patient monitoring use cases.

[00:17:34] Bill Russell: [00:17:34] All right. So maybe I’ve been out of the game a little too long, the frog app is what they do to reserve a parking spot? 

[00:17:42] Patrick Anderson: [00:17:42] That is correct. It’s a mobile platform and they can they can sign up for their destination and then it will, we have a puck on every every parking spot on our campus now. And we’re building a couple parking structures [00:18:00] as well, and they will all have the frog puck as well. And we’ll assign parking prior to people arriving. 

[00:18:07] Bill Russell: [00:18:07] Well, I mean, that company should do pretty well in Chicago, New York, LA, Orange County. And that parking is a serious problem at hospitals. That’s great. 

[00:18:19] Patrick Anderson: [00:18:19] It sure is. Well this company, I think, built their their capabilities out of airport parking lots. So it’s working pretty good for us. 

[00:18:28] Bill Russell: [00:18:28] Yeah. [00:18:30] Do you have any projects around your major systems that EHR PACS, ERP, CRM. 

[00:18:36] Patrick Anderson: [00:18:36] Absolutely. We’re working with some of the bigger integrators for ERP and for future value of enterprise systems. We’re really focusing in three enterprise areas Bill. We’re looking at ERP. We’re also looking at the clinical enterprise and we’re looking at the research enterprise and we’re [00:19:00] we’re working with you know, some of these top integrators. What does the future look like? What is the value that we can expect and what value can an integrate or bring with us to maybe partner with with getting that value, you know, having some skin in the game on that. So we’re doing, long-term planning on the business enterprise, the clinical enterprise and the research enterprise. And we plan to create multi-year roadmaps, multi-year [00:19:30] funding to upgrade the the enterprise platforms for all three of those enterprises so that we can optimize value because we’re just growing significantly and we need.

[00:19:42] We need automation everywhere, we need chat bots. We need artificial intelligence. We need prescriptive analytics. We need it all to sustain our growth. So it’s an exciting time to be in advanced cancer. 

[00:19:58] Bill Russell: [00:19:58] So, so you need, [00:20:00] I mean, you need it all, but last year was a, I just came back from the JPM conference. Didn’t come back. I mean, I sat at this very desk and watched, you know, 16 health systems talk about how their volumes were down between probably between March and May was the predominant drop in volumes and then a return, but not really returned to a hundred percent through the remainder of the year.

[00:20:22] And so are there any projects that just from a fiscal standpoint that, that have dropped by the wayside that you’re like, Hey, you know what that’s [00:20:30] a nice to have and we’ll get back to that later. Are there any of those?

[00:20:35] Patrick Anderson: [00:20:35] There were, there were many of those, especially in the clinical enterprise. We had to slow everything down and then we weren’t sure what the funding was going to be like for 2021. So we’re we’re being very, we’ve slowed everything down. We have major initiatives that are still moving forward, such as precision medicine, our oncology learning platform. You know Orange County and all of the other [00:21:00] construction that we have going on.

[00:21:02] And just another host of about 150 projects, but we’re slowing everything down. That’s discretionary, sort of how you mentioned it Bill, anything that’s discretionary. We’re going to hold and wait, we’re reducing our up our spend, wherever we can. Waiting for the the return of better better volumes, better patient volumes to, to drive the drive the revenue needed for [00:21:30] us to pick up the pace again on our priorities. 

[00:21:34] Bill Russell: [00:21:34] Wow. Man, you are probably one of the most succinct interviews I’ve ever done. I mean, you just, you hit the, you hit the points, I guess that speaks to the fact that you are your time is in high demand at this point. So you’re used to answering the questions and moving on, I guess.

[00:21:56] Patrick Anderson: [00:21:56] Well, you know, I have a great team bill. We have, we have a great team. We [00:22:00] huddle a couple of times a week and we’re really focused on inter-operating. We have a playbook and the playbook grows and the playbook learns. You know, we run the IT department here with a leadership team and we run it through the playbook, the dashboards. And every time we find areas of weakness, we just, we drive KPIs towards that. We monitor it for a year and then once it’s stabilized and claim, then we drop it and we [00:22:30] look for other opportunities to improve. So having a completely aligned leadership team really, really makes the big difference.

[00:22:38] Bill Russell: [00:22:38] You know, I’ve asked a lot of CEOs about their KPIs and it’s really interesting cause they’re all over the board that you would think that at this point in our industry, we would have like a standard set of KPIs. And I clearly people look it up time and whatnot. But but they’re really all over the board.

[00:22:58] And a lot of it depends [00:23:00] on what type of institution, if you’re an academic medical center, if you’re a research institution, if you’re you know, it’s, it’s your cancer and blood disorders and those kinds of you’re going to have a different potentially set of KPIs and others. And that’s, that’s one of the things I’ve found really interesting as I was having these conversations, but, but you have a pretty solid set of KPIs around what you’re trying to drive towards.

[00:23:25] Patrick Anderson: [00:23:25] That’s right. And it’s really based on on supporting the [00:23:30] CMIO and his clinical informatics as well as the CFO and their needs, and then research as well. And we have service level agreements. We have KPIs, we have dashboards, we monitor the health of it, service delivery, as well as we have an amazing PMO and we really watch the the performance of our projects very, very carefully.

[00:23:59] And we have [00:24:00] a very comprehensive governance Bill. We have five governance committees over five areas of the. Of the business. And then they all roll up to an enterprise governance that I chair with all of the business leaders that govern those enterprise areas. And we drive that alignment. So I’m driving alignment in the business and then I’m driving alignment within it.

[00:24:23] And if you can keep all of that heavily coordinated. Then then all you’re working on [00:24:30] is really the exceptions and you’re bringing those exceptions forward into alignment. And that’s what the KPIs do. 

[00:24:36] Bill Russell: [00:24:36] That’s fantastic. What’s what’s your EHR? 

[00:24:40] Patrick Anderson: [00:24:40] Epic. 

[00:24:41] Bill Russell: [00:24:41] You’re an Epic shop or are you pretty you know, given what you guys are doing, are you close to foundation or is it highly customized?

[00:24:50] Patrick Anderson: [00:24:50] We’re close to foundation, but we still have a lot to do. Our Epic implementation is only three years old. You know, and you look at other organizations that have had it [00:25:00] 15 or 20 years, they’re, much more effective than us. We’re still doing a lot of manual work. And we have a lot of work to do and the pandemic really slowed us down. But but we’re we’re getting there. 

[00:25:14] Bill Russell: [00:25:14] No, that’s fantastic, Patrick, as always. Thank you for your time. It’s I love your wisdom. If people want to hear about the playbook, we actually did an episode on the playbook where you shared the components of that. That’s they’ll have to dig back into the archives.

[00:25:29] That was [00:25:30] wow. What was that? Three years ago now? 

[00:25:32] Patrick Anderson: [00:25:32] Yeah. And I’ll tell you that playbook has evolved. 

[00:25:35] Bill Russell: [00:25:35] Well, maybe we’ll have to next time. Next time you come on. Well, maybe we’ll have to revisit the playbook and go through that. 

[00:25:42] Patrick Anderson: [00:25:42] Sounds fun. Sounds good Bill. 

[00:25:44] Bill Russell: [00:25:44] Thank you, sir. Take care. 

[00:25:45] Patrick Anderson: [00:25:45] All right. Take care.

[00:25:46]Bill Russell: [00:25:46] What a great discussion. If you know someone that might benefit from our channel from these kinds of discussions, please forward them a note. They can subscribe on our website or you can go to wherever you listen to podcasts, Apple, [00:26:00] Google, Overcast, that’s what I use. Spotify, Stitcher. We’re out there. You can find us. Go ahead, subscribe today or send a note to someone and have them subscribe. We want to thank our channel sponsors who are investing in our mission to develop the next generation of health IT leaders. Those are VMware, Hill-Rom and Starbridge Advisors. Thanks for listening. That’s all for now.

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