Making the EHR Transition with Andrew Cooper
April 23, 2021

 – Episode #

394

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April 23, 2021: What’s the difference between IT in banking and IT in healthcare? Meet Andrew Cooper, Executive Director of IT for NCH Healthcare System who shares how he went from a financial career to his current position. His number one project is moving the EHR from Cerner to Epic. It can be hard. It can be painful but it will set you up for long-term success. What is the challenge of trying to stay as true to foundation as possible? Or do you need to try and customize all the time? What is the key to putting together the best team to ensure a successful project? How do you keep your staff trained and engaged?

Key Points:

  • There’s a case to be made that you should be able to run a hospital with as close to a standard build as possible [00:14:30]  
  • If we can’t share information freely in the community and with other healthcare organizations then there’s no point in doing the EHR [00:22:25] 
  • We’re doing the conversion with a full enterprise archival platform. All of our legacy systems will move into that. [00:24:09] 
  • The list of requests we got during COVID was so long but my team was able to come up with something to support every single request [00:32:20] 
  • We were paralyzed during COVID and had to custom build everything because we had customized our environment so much [00:36:00] 
  • NCH Healthcare System

Making the EHR Transition with Andrew Cooper

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Making the EHR Transition with Andrew Cooper

Episode 394: Transcript – April 23, 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’s show is a little bit for you, a little bit for me. I’m expanding my network here in Southern Southwest Florida and I met Andrew Cooper who’s the Executive Director over at NCH, which is one of the hospitals here in Naples, [00:00:30] Florida. They’re getting ready to do an Epic implementation across their entire footprint. And we caught up with him. Had a great conversation around what they’re doing, how they’re planning for that, how they are thinking through that kind of implementation, especially during the middle of the COVID pandemic that is going on. So great conversation. Hope you enjoy. 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 [00:01:00] 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]

[00:01:06]I want to take a quick minute to remind everyone of our social media presence. We have a lot of stuff going on on social media. You can follow me personally Bill J Russell on LinkedIn. I engage almost every day in a conversation with the community around some health IT topic. You can also follow the show at This Week in Health IT on LinkedIn. You can follow us on Twitter Bill Russell H I T. [00:01:30] You can follow the show This Week in Health HIT on Twitter as well. 

[00:01:35] We’ve got a lot of different things going on. Each one of those channels has different content. That’s coming out through it. We don’t do the same thing across all of our channels. We don’t blanket posts. We don’t just schedule a whole bunch of stuff and it goes out there. We’re actually pretty active in trying to really take a conversation you know in a direction that’s appropriate for those specific channels. So we spend a lot of time on this. We really want to engage [00:02:00] with you guys through this. We are trying to build a more broad community. So invite your friends in to follow us as well. We want to make this a dynamic conversation between us so that we can move and advance healthcare forward.

[00:02:14] 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, [00:02:30] Stitcher, Overcast. You name it, we’re out there. You can also go to todayinhealthit.com. And now onto today’s show. 

[00:02:38] This afternoon, we have Andrew Cooper with us. I’ve started to do my networking around the city that I moved to. A year ago I moved to Naples, Florida and Andrew is the Executive Director of IT at NCH here in Naples, Florida. Andrew, welcome to the show. 

[00:02:53] Andrew Cooper: [00:02:53] Great. Thank you. Glad to be here. 

[00:02:56] Bill Russell: [00:02:56] Yeah, but we, we connected through Sarah [00:03:00] Richardson and how are you connected with Sarah? 

[00:03:04] Andrew Cooper: [00:03:04] So Sarah worked for NCH for and actually hired me into my original position here.

[00:03:10] Bill Russell: [00:03:10] Wow. Well, Sarah is an advisor to This week in Health IT. She’s been with us helping us to guide our growth and direction for a couple of years. It sounds like she was integral in your growth and direction as well. 

[00:03:24] Andrew Cooper: [00:03:24] Absolutely. Yeah, she was the key factor as to why I chose to come here to Naples.

[00:03:29] Bill Russell: [00:03:29] I’m trying [00:03:30] to figure out why she left Naples. Well, I guess she went to Southern California. We went in the opposite directions. I went from Southern California to Naples. She went from Naples to Southern California. 

[00:03:40] Andrew Cooper: [00:03:40] Absolutely. I think it’s a win-win either direction you go. 

[00:03:44] Bill Russell: [00:03:44] Yeah, there are, there are worst places to be in the country, for sure. So tell us a little bit about NCH. 

[00:03:52] Andrew Cooper: [00:03:52] Sure. So NCH is Naples community hospital. We’re a healthcare system to hospital system based in Naples, Florida. [00:04:00] We have a large ambulatory presence throughout Collier County and Southern Lee County as well. So a very prestigious organization high quality, high marks in almost everything that we do. So it’s a very exciting organization to be a part of. 

[00:04:17] Bill Russell: [00:04:17] Yeah, absolutely. So what was your path to get to the executive director of IT at NCH? 

[00:04:23] Andrew Cooper: [00:04:23] Oh, so it’s, you know, we could go back, you know, 10, 15, 20 years here but essentially I [00:04:30] started my professional career off in banking and was hired right after an EF five tornado wiped out a couple community banks in the Area that I lived in.

[00:04:42] So I started working for them as an intern, long story short, they offered me a full-time job. I completed school there. And graduated as their AVP over it. I’m really sorry, 

[00:04:52] Bill Russell: [00:04:52] I’m sorry an F five tornado. So that must have been in the Midwest, I assume. 

[00:04:55] Andrew Cooper: [00:04:55] Yes. Yep. That was in Nebraska. You have five tornado [00:05:00] which if people don’t know tornadoes is the strongest of tornadoes. So yeah, obviously it was life altering for quite some people 

[00:05:10] Bill Russell: [00:05:10] So comparing contrast and F five tornado and Hurricane Irma. 

[00:05:16] Andrew Cooper: [00:05:16] Ooh. So, on any given day, I would live through a hurricane again, before I would live through a tornado. At least with a hurricane, you have general idea of when it’s going [00:05:30] to come at you and you know, kind of you know, there’s still a lot of unknowns with it.

[00:05:35] And hurricanes are not fun by any means but you have a lot more time to plan and prep. Whereas a tornado, you can have a matter of seconds to get into the basement and you know, truly down here, at least in Southern Florida construction, everything is designed to withstand a hurricane and you just can’t really do that for a tornado.

[00:05:53] Bill Russell: [00:05:53] So a hurricane doesn’t surprise you, but you know that the movie Twister really is true. An F five [00:06:00] good come up out of nowhere and just take a left turn and head towards your town. 

[00:06:05] Andrew Cooper: [00:06:05] Yep. Essentially it will level ,F five will level everything in its path. 

[00:06:10] Bill Russell: [00:06:10] Well, I remember the, I don’t know if it was F five, but the hurricane or the tornado that hit Joplin actually moved the hospital.

[00:06:19] Think about this. It moved the hospital off its foundation. And it only moved it a couple of inches, but it was enough to condemn the building. 

[00:06:27] Andrew Cooper: [00:06:27] Yep. Absolutely. 

[00:06:29] Bill Russell: [00:06:29] That’s amazing. [00:06:30] I can’t imagine the power of a tornado. I’m sorry. I got sidetracked there a little bit. So you were in banking, how’d you get into healthcare?

[00:06:38] Andrew Cooper: [00:06:38] So while I was in banking, I did a lot of mergers acquisitions and really had gotten to a point where I had optimized I kind of done everything I needed to do for that organization. And quite frankly, I was getting a little bored. And so my mentor at the time rec recommended that I go back and get my master’s degree focused on my CIS SP.

[00:06:57] And then she said, you know healthcare really needs [00:07:00] individuals like me. And so she really pushed me to look at healthcare. So I took that opportunity, joined a small 115 bed hospital in South central Missouri. After the bank. Was there for a short time. Became a director of Information Security for a level one indigent care hospital in Memphis, Tennessee.

[00:07:21] And then Sarah and I connected and was offered the position here at NCH. I’ve had a lot of roles here at NCH. I started as the Director of [00:07:30] Information Security. Took over, at that time it was all completely outsourced so Sarah and I were the only two IT individuals. And then over time I’ve taken over  all IToperations to the Executive Director role and we have insourced our IT department as of 2018.

[00:07:50] Bill Russell: [00:07:50] Wow. Yeah. So I, you know, I did an insource. That’s not as easy as what people think. I inherited an insource in that they [00:08:00] and we’re talking a sizeable, you know, ten-year outsource to Dell pro. And then, and then the. CIO before me started the insource. And then I did the insource. You have to build everything from scratch.

[00:08:11] I mean you know, job classifications. You have to build the career paths .You have to build you know processes, procedures you know, just, it was amazing how much you have to do on an insource that I don’t think people would be, I think people would be surprised how much [00:08:30] you have to do. 

[00:08:31] Andrew Cooper: [00:08:31] And of all that list. I think writing 80 some job descriptions was the hardest part. Just trying to just create them all, keep track of all of them. But yeah, you know, it really gave us, it gave us an opportunity to look back and say, what do we as a leadership team, want to do different within IT and kind of build that groundwork from from the start.

[00:08:51] And I will say in the short amount of time that we’ve been insourced, we’ve really built a fantastic team. 

[00:08:58] Bill Russell: [00:08:58] Well, so you’re in [00:09:00] healthcare now. What’s the equivalent to an EHR project in banking? Is there an equivalent. 

[00:09:07] Andrew Cooper: [00:09:07] So in banking they use, what’s referred to as a core system. So that is your your main banking’s offer that has everything that interfaces in and out of it. And I have been through seven we’ll call it mergers or conversions on banking, software and banking is quite a bit easier than an EHR conversion. When you look at changing out the technology. 

[00:09:30] [00:09:29] Bill Russell: [00:09:29] Why, why is that? 

[00:09:32] Andrew Cooper: [00:09:32] Well, A, you don’t have to worry about radiology, the images and how large those are and trying to figure out how those are going to live in everything. And you know, in banking, it’s it’s a lot more black and white. You know, you have credits, you have debits, you have check it what today you probably don’t have near as many check images coming in. But it is, you know, you’re not dealing with the full body, the full human aspect in the banking [00:10:00] environment.

[00:10:00] Bill Russell: [00:10:00] So a lot, a lot more data elements, a lot more images, a lot more distinct systems. I mean, that’s one of the things I’ve done. I did work at Bank of America and some other places. And then when I got into healthcare, I was shocked to find, you know, 900 different applications at our health system. And then you start digging in and you realize there is a bunch of redundancy, obviously.

[00:10:21] But each there was software written for such specific task within healthcare really was kind of [00:10:30] amazing. 

[00:10:30] Andrew Cooper: [00:10:30] Right. Yeah, absolutely. And I think really in banking too you had a, they were using technology a lot longer. They had been using technology a lot longer than healthcare, you know. And so you really were, had processes and you had really applications, which were we in healthcare are getting there very, very rapidly.

[00:10:53] Bill Russell: [00:10:53] So you’re starting your EHR project. It’s right around the corner. Is that, is that accurate? 

[00:11:00] [00:11:00] Andrew Cooper: [00:11:00] Yes. Yep. So the board approved in November for for us to do our EHR conversion. The official kickoff right now, we’re in the pre-work phase. The official kickoff will be the June timeframe with June of 2022 to go live. So it’d be a very quick implementation. 

[00:11:17] Bill Russell: [00:11:17] Wow. That is, well it’s so two hospital system, do you have clinics and a lot of outpatient as well?

[00:11:25] Andrew Cooper: [00:11:25] Yeah we have have about 40. 40 plus ambulatory [00:11:30] facilities. You know, overall we have about 7,000 users in our environment and it’s a combination of medical staff, employees, contractors etc. 

[00:11:37] Bill Russell: [00:11:37] Are, are you relying? I assume you’re relying on a vendor or contractors to help you to do this. 

[00:11:43] Andrew Cooper: [00:11:43] So we are actually, the EHR vendors is obviously going to help us quite a bit with the implementation. But overall you’re only pulling a very small subset of contractors. I want to say in just of quick count four or five. And it’s really to [00:12:00] augment us where we need to be augmented.

[00:12:02] So what we’re planning on doing is implementing kind of an out of the box EMR which you know, we’re, it’s kind of a new technology or a new term, but really what’s being delivered to us is going to be about 95 or 95%. 95 to 98% pre-configured when it comes to us and then we just do the personalization that we need on top of that.

[00:12:25] Bill Russell: [00:12:25] So are, and you can say the vendor, I assume you’re going to Epic. 

[00:12:29] Andrew Cooper: [00:12:29] Yes. Yep. [00:12:30] We are converting from Cerner to Epic. 

[00:12:31] Bill Russell: [00:12:31] So you’re going to stay as close to foundation as you possibly can. 

[00:12:35] Andrew Cooper: [00:12:35] Stay true to foundation is one of our guiding principles. And one of the things that we talk about with the executive team every single time, and it’s truly because it feeds analytics, it feeds its training, test scripts. Everything that we are planning on doing is built into the foundation. 

[00:12:53] Bill Russell: [00:12:53] Wow. That’s really fascinating. So what is the challenge of trying to stay as true to [00:13:00] foundation as possible? Do you find you’re being cooled to try to customize all the time? 

[00:13:04] Andrew Cooper: [00:13:04] So, you know we really haven’t gotten into those workflow walkthroughs and then started to talk about where we need to deviate from foundation yet.

[00:13:15] But we are coming from a completely customized EHR and that’s not a reflection of the vendor. That is truly just us as an organization over the 20 plus years that we’ve used that technology that we have customized it. And so I, my [00:13:30] personal opinion is I think the biggest challenge is going to be getting away from customization in general and having to adapt workflows and things that we as an organization do to match  what is recommended in the software. 

[00:13:43] Bill Russell: [00:13:43] Right. So that’s really changing the culture. I mean there’s a cultural mindset that comes with customization. We did a significant EHR build out and whatnot.

[00:13:52] And the number of times you hear, yes but we’re different and I’m sitting there going, how different can we be? There are thousands of hospitals [00:14:00] across the country. Now I understand if we’re doing you know, something, you know, Mayo ask or UCLA medical center, as you know we’re doing academic kind of stuff. But the general community hospital or integrated delivery network, it really shouldn’t have, I mean this is me talking, I’m not putting words in your mouth, but it really shouldn’t have to go too far outside the standard build [00:14:30] I guess. If you can, if you can pull it off there’s a case to be made that you should be able to run the hospital with as close to a standard build as possible. 

[00:14:41] Andrew Cooper: [00:14:41] Absolutely. And that’s why it’s part of our guiding principles. So the foundation system is built off of. The best practices of all organizations that are using Epic.

[00:14:52] And so, you know whether that’s Cleveland Clinic or Mayo, or, you know even other local [00:15:00] organizations here that may be using Epic. You know all that information, all their their best practices go into that foundation system for us to leverage. So yeah, I think we’re really excited about that,cause we’ve really, we’ve really felt some of the struggles with the system that we’ve customized over time.

[00:15:19] Bill Russell: [00:15:19] So I talked to some people that when they did, when went through this process, they ended up putting their staff on the EHR project and then they back-filled [00:15:30] for the existing system. And I’ve seen, I’ve talked to others that essentially brought in, the vendor did a majority of the migration to the new system and their team continued to do what they were doing. Which direction did you go?

[00:15:42] Andrew Cooper: [00:15:42] So we are actually pulling individuals into the IT department. So we are growing by about 35 to 45 individuals within the IT department to take on the conversion to Epic and truly Epic has given us that staffing guide of how many positions do we need during [00:16:00] the interim, long-term as well and really the interim to long-term there was maybe just a few positions in there. And we know over time that there’s, you know, individuals are going to choose to leave us. And so instead of pulling contractors in that are going to take all that knowledge to the minute they walk out the door we actually just bumped up our FTE count during the implementation to ensure that we could cover everything. 

[00:16:24] Bill Russell: [00:16:24] Wha, people are going to leave Naples. I don’t know what’s going on. Did you set some [00:16:30] goals for this to sort of guide the project in terms of success metrics, KPIs, those kinds of things?

[00:16:37] Andrew Cooper: [00:16:37] So we are, originally when we were planning the project and everything we looked at you know very high level improvement, quality, improved patients, patient satisfaction, physician satisfaction. We looked at those. We’re currently in the process of going back and tying the metrics to that. And really it is a comparison of what can we get out of our current system as [00:17:00] opposed to what we can get out of the new system. And so as we build out our governance structure there each of the sub committees will have their key metrics that they track and report back to the EHR governance at the highest level governance committee in the project.

[00:17:14] Bill Russell: [00:17:14] What was the primary driver to go to Epic? I mean, what was the deciding factor? 

[00:17:20] Andrew Cooper: [00:17:20] So really some of the, we’ve had a lot of challenges. And again, a lot of this is because of the customization that we’ve done over time. And [00:17:30] you know we didn’t necessarily always acquire the appropriate modules that we needed in our current system.

[00:17:37] And so we would do a lot of custom build. And so we really wanted to take a step back and say, how do we kind of set ourselves up for better success long-term. And  we did the side by side between basically a complete new install of Cerner or converting to Epic and really as we got into it, looked at it you know converting to Epic for us was the right decision.

[00:17:59] Because [00:18:00] it has the completely integrated revenue cycle. Today our ambulatory revenue cycle is on a completely different system and there’s some manual entry and stuff that has to occur from that. You know, data analytics in, was very important to us and it’s not somewhere that we’ve gotten very far in it again because of a lot of the disparate systems that we have.

[00:18:21] So you know, really, as we looked into it you know, there were so many things that, that really pointed to doing the conversion was the [00:18:30] right thing for us. 

[00:18:31] Bill Russell: [00:18:31] Yeah. So, you know, I was, I was going to ask you about your projects going into 2021 and 2022. But I assume this is going to, are you going to be doing things outside of this project or is this pretty all encompassing?

[00:18:44] Andrew Cooper: [00:18:44] So this is pretty much all encompassing and it is this is on the strategic plan for the organization. As our CEO has said, this is one of, if not the top project for the next 18 months, obviously it was a few months ago when we talked about it for the [00:19:00] organization. And so our current environment entered into what we refer to as break-fix regulatory only mode as of March 1st.

[00:19:07] So we won’t even be investing a lot of time into building, building that system. Obviously we have to maintain it. If there’s regulatory changes, we have to do that. But truly the focus starting as of April 1st, we’ll be building the Epic system out and doing the conversion. 

[00:19:23] Bill Russell: [00:19:23] So this, this is Bbill Russell hitting you up for some free information. So what are you gonna do for me the consumer? I mean, I assume you’re gonna use [00:19:30] Epic’s tools. I’m going to be seeing MyChart. And are there any other things you’re thinking in terms of the digital landscape for consumers in the market? 

[00:19:40] Andrew Cooper: [00:19:40] So the big, the biggest thing that we’re doing you know out of the gate is really that patient engagement. And I will be the first one to say that not too long ago, I had to go see my primary care physician and they handed me the clipboard that was like 12 pages long at the same information that I had just completed you know, a few, what felt like a few weeks ago. [00:20:00] And so, you know being able to pull that into the, my chart, into the patient portal, get that information when it’s convenient for me as the consumer is on our roadmap. Doing the online scheduling, being able to schedule appointments and not have to call into the facilities. You know, there’s a lot of cool things that we’ll be able to do, long-term with integrated devices and stuff like that. But really out of the gate is kind of like for like where can we make the biggest biggest impact changes?

[00:20:30] [00:20:30] And then phase two will be kind of the optimization pulling in some of that other cool technology. 

[00:20:35] Bill Russell: [00:20:35] Yeah. I hate to do this to you, but my my father-in-law actually went to one of your competitors over on pine Ridge. And their experience is actually from a digital standpoint was actually pretty pretty good. I was gonna, I was, I was kinda surprised. I mean, obviously they’re already an Epic shop and a lot of it is based on that Epic foundation. So you guys, you guys will be [00:21:00] able to catch up. Talk about interoperability on that side as well. So I assume a majority of the health systems in Southern Florida are on Epic. Am I correct? 

[00:21:10] Andrew Cooper: [00:21:10] So there’s actually a big shift that’s occurring right now from Cerner to Epic. And interestingly enough, the one that you’re referring to is on Cerner. They’re on a Cerner platform. Our neighbors to the North are on Epic. And so, you know Abbott Health from Orlando is in the process of [00:21:30] converting you know, Lakeland Health. There are several organizations here within Florida that are in the process of converting onto the Epic platform. 

[00:21:40] Bill Russell: [00:21:40] You know, I that’s interesting, I didn’t know. I didn’t ask which EHR, if they were on but it just felt like it was it was pretty, it was pretty smooth. I was kind of surprised. So what about HIE?

[00:21:50] What about, what about information exchange? I mean, is there a good strategy to move information around in this market? 

[00:21:59] Andrew Cooper: [00:21:59] Yeah, [00:22:00] absolutely. And that’s interestingly enough tomorrow we have our executive kickoff for our team and one of the main topics is interoperability. And you know with Epic, there’s multiple different ways to do that interoperability.

[00:22:12] But when we set up, set out initially to start talking about this convert, talking about the conversion which at this point it’s been almost two years since we started talking about it. It was the number one thing that we talked about is if we can’t share information freely in the community and with other [00:22:30] healthcare organizations there’s no point in us doing it, so we’ve really, doing the conversion. So we’ve absolutely had at the forefront. It was included in our contract for day one. And there again, there’s many different ways to do it. You know, for us in, you know, MayoI know it’s well known that Mayo’s on Epic. We refer a lot of patients there.

[00:22:51] We can send information back and forth real easily and then even organizations that aren’t on Epic we’re able to leverage either direct connections or through an [00:23:00] HIE to share that information as well. 

[00:23:02] Bill Russell: [00:23:02] How does, so you know, w w what information did you decide to bring across from the, from the old platform? Is it the traditional pammy stuff, or are you brain trying to bring in as much across as possible? 

[00:23:14] Andrew Cooper: [00:23:14] So you’re hitting on all this stuff that I’ve actually talked about multiple times this week internally for the organization. And this, we’ve not actually set our true data migration plans yet.

[00:23:28] And so that is one of the [00:23:30] next big things for us to figure out. And, you know, really the stance that we are taking is we have a brand new, nice, neat, shiny system. And the last thing we want to do is take information. And again, this is not a reflection of the system, but the data that’s been put into that system over 20 plus years and convert that into nice new a system.

[00:23:50] So we’re working to get a group together to be able to determine the quantity of information that we’re going to move over. And then, and where you’re going to [00:24:00] leverage some of that HIE I’m functionality to be to make sure that we can put stuff into a holding tank and actually have it ingested into Epic at the right time.

[00:24:09] But we’re also doing that coupled with a full enterprise archival platform. So all of our legacy systems are going to move into that archival platform. So our physicians aren’t going to have to go to three or four different applications to find all the information on the patient. They’ll go to want, and it’ll all be listed there. So we’ve already signed that contract and we will kick that project [00:24:30] off with the summer in advance of the conversion. 

[00:24:32] Bill Russell: [00:24:32] Yeah. Just out of curiosity, your enterprise archive solution is what? 

[00:24:37] Andrew Cooper: [00:24:37] It is Triam.

[00:24:39] Bill Russell: [00:24:39] Okay, cool. Well, it’ll be interesting. We’ll have stuff to talk about a year from now. 

[00:24:44] Andrew Cooper: [00:24:44] Absolutely. We’re really excited about this. 

[00:24:47] Bill Russell: [00:24:47] Yeah, it’ll be, it’ll be interesting. So, so talk to me about your so I’m going to change topics a little bit here talk, talk to me about your staff and keeping them trained, obviously retention. [00:25:00] You know, I’ve heard this a couple of times now. It is beautiful down here but retention in Naples is is hard for a lot of different businesses.

[00:25:09] You know, what kind of, what kind of things have you put in place to keep your staff engaged, keep them trained and those kinds of things? 

[00:25:16] Andrew Cooper: [00:25:16] Sure. Absolutely. So really, you know, when we built our new ITdepartment in 2018 we, for we as an IT for NCH was one of the first departments to go [00:25:30] virtual. And we actually started with it with testing the waters and to start off, we had about 30% of our staff that was completely virtual, meaning they didn’t necessarily, they may live in Florida but they didn’t have to live in Naples and commute into a facility. And so that really allowed us to get top talent from across the United States.

[00:25:48] We have individuals tat are, that are in California. We just extended an offer to somebody who’s actually going to be living in Jamaica. And so we’re really excited about that. Being able [00:26:00] to leverage leverage the entire popular and not force individuals to move here. We, we do have staff that have to be here on site and the organization just made some major announcements with some changes and it actually impacts all employees with some changes on benefits and in raises and stuff like that to help keep them engaged. Because it has been, it’s been a challenging year for everybody in healthcare. And so our organization is really taking some steps [00:26:30] to really improve the employee engagement as we continue to move forward.

[00:26:36]From a training standpoint. So this has been something that has been built into our plans from day one. And you know, I can’t think of a single time that we have turned down a request for someone to go off to training or, you know, to attend something assuming that it makes sense for their position.

[00:26:56] While we were still with Cerner, we had what Cerner refers [00:27:00] to as there, just blanking on the name but basically an all you can eat a training program where our staff can go and take classes. And  our staff took fantastic classes and learned a lot on the Cerner system. From an Epic standpoint, obviously they’ll have to go through that certification process and everything, but you know, we really look at any opportunity, whether it’s service now or other applications to they give training credits and really continue to advance our team’s ability. 

[00:27:30] [00:27:30] Bill Russell: [00:27:30] Yeah. And that sort of gets to my next question, which is are there  areas where the staff has to learn new skills or new tools that you’re that you anticipate over the next year and a half? 

[00:27:41] Andrew Cooper: [00:27:41] Yeah, so absolutely. You know, We have, between last week and next week we have about 30 to 45 individuals moving into the IT department. And so what we, as an it leadership have decided to do is actually go back and reorient our entire team. [00:28:00] So all the new individuals are learning at the same time as our staff. And you know, it’s simple things like WebEx and teams and service now, and X matters that we use for paging and you know simple, simple, everyday use items like that. On top of all the all the Epic training and all the new third party training that that team’s going to have to go through as well. 

[00:28:23] Bill Russell: [00:28:23] Wow. So is orientation very different in a COVID world? 

[00:28:30] [00:28:30] Andrew Cooper: [00:28:30] So for us, you know, really yeah we used to do quite a few meetings meetings in person. Cause again we have people that are here locally but we’ve gone down to probably I’d say less than 10% are that are onsite on a routine basis. And so what we’ve actually learned is it’s much easier if either everybody’s virtual or everybody’s in the room. The hybrid approach becomes really, really difficult, especially, you know, people are having anxiety conversations and stuff like [00:29:00] that.

[00:29:00] So being virtual has really allowed us and to be, I think be a lot more productive. Schedule meetings a lot quicker than we’ve been able to do. Or orient people a lot quicker than we’ve been able to. 

[00:29:12] Bill Russell: [00:29:12] Yeah. So your COVID journey probably wasn’t as challenging as others. If you were, you had a fairly sizable headstart in terms of the remote work aspect that everybody had to do.

[00:29:25] So I assume that that jump for your house was some was [00:29:30] not all that challenging for the IT organization. 

[00:29:33] Andrew Cooper: [00:29:33] For IT no. Cause even the, you know the other 30, 40% that were onsite employees we’re still working from home on a routine basis. Whether it was one or two, three days a week. So they were going kind of through that rotation process. So they were kind of used to it. You know, I think the biggest thing is we just made sure that everybody had the hardware, the web cameras, the monitors, everything that they needed [00:30:00] that they didn’t necessarily have if they were not a hundred percent virtual before that. 

[00:30:05] Bill Russell: [00:30:05] Did you do Ms. Teams, or are you a WebEx shop? 

[00:30:08] Andrew Cooper: [00:30:08] So we we use WebEx for the bulk of our meetings when it involves people outside of just IT. We do have Teams as well that we use for it. But we find that  people use Webex. Or is it maybe a little bit easier to use WebEx for non-technical people.

[00:30:28] Bill Russell: [00:30:28] Yeah. Well, [00:30:30] if you say so. I find Zoom to be the easiest to use But you know when COVID first started it wasn’t the most secure platform out there. So obviously they’ve made some great strides since then to short up. You know, I mean just talking about COVID, I mean was there you know, outside of work from home, we had a lot of different things that went on in the hospital.

[00:30:56] Was there anything, any interesting requests [00:31:00] that you got as the leader of IT around you know, helping to keep frontline staff safe or anything to that effect. 

[00:31:11] Andrew Cooper: [00:31:11] Yeah. And you know, first, I want to start by saying that our team, the IT team, the entire organization, I feel we did a fantastic job with responding to COVID. And you know, there were items for example in Cerner, there’s a banner bar and it just gives basic information on patients [00:31:30] and there was a lot of custom build that our team had to do to say whether or not the patient was positive or if they’ve been tested and all that information. So it shows up at the top to be able to keep people, both keep our patients and keep our employees safe. You know, there were, at one point there were triaged tens that are outside in the emergency department, parking lots that our team had to equip you know, I had to put workstations in it, make sure all that equipment and everything is out there and functioning. You know, we had [00:32:00] drive through your testing and so the it department had to. Put information or put systems together and stuff to be able to make efficient processes out there in the driver theater and even myself there were for about a two week period.

[00:32:13] I was the IT representative that worked out in the drive-through so that we could help work those processes. I was here on site. And so, you know, really the list of requests that we got during COVID you know is so long that I couldn’t probably isolate [00:32:30] many items but, you know, our team was able to our team was able to come up with something to support every single request. 

[00:32:37] Bill Russell: [00:32:37] When was our surge? Or did we have multiple surges? I, to be honest with you, I’m living here and people have asked me, like you know, when was your surge in Southwest Florida? I’m like, I think it was when everybody else’s was but it wasn’t obvious to me. It wasn’t my, you know, the hospitals were overflowing from my perspective but you’re in the hospital. Was there, [00:33:00] was there a big surge at one point? 

[00:33:02] Andrew Cooper: [00:33:02] So summer of 2021. So that July, June, July, August timeframe of 2021 is when we I’m sorry, 2020. I’m always thinking ahead to next year with the Epic conversion. Summer of 2020 was the highest peak, the surge that we as an organization had. And of course, you know, it’s ebbed and flowed through there but we never got near the level that we were last summer.

[00:33:26] Bill Russell: [00:33:26] Yeah, we were, yeah,  we, we can go down there but this is an IT [00:33:30] show. So I’m not going to ask you about stats and those kinds of things. Are you guys participating in the vaccine? I assume you’re a part of the vaccine rollout in Southwest Florida. As are the other health systems I assume.

[00:33:44] Andrew Cooper: [00:33:44] Yeah, absolutely. So our F first initial shipment was earmarked for healthcare professionals. So we, I think we had roughly 5,000 vaccinations in the first shipment for [00:34:00] for healthcare workers focus those, then we went to EMS. So we’ve helped a lot with the first responders stuff like that.

[00:34:07] And we’ve had around the 1500, 2000 about vaccinations available for community members as well. You know, my, I personally have not seen us get a lot more shipments in for us to continue with the community. So I imagine a lot of that’s going through like Publix, the grocery [00:34:30] stores, the pharmacies which just, you know, truly have more facilities more capacity to take on some of those vaccination efforts.

[00:34:38] Bill Russell: [00:34:38] Yeah. Yeah, absolutely. So  we’ll have to see where that, where that goes. I mean, Yeah, you guys are doing an EHR plan. As you know, COVID’s hitting, you’re ramping up things for work from home and, and other types of initiatives to support. COVID. I you, I’m just [00:35:00] curious, you know, w what do you think the lasting impact of COVID is going to be on the way that your health IT team operates?

[00:35:08] Andrew Cooper: [00:35:08] We were, interestingly enough, my boss and I were talking about this just the other day, because in the middle of, you know, an EHR conversion and all this fun stuff. We as an organization have acquired another facility and a moving one of our operation facilities into this new, to this new building.

[00:35:25] And the conversation was what space  doyou need for IT? And I said, I [00:35:30] personally had no intention of bringing more staff to be onsite. And really, you know, want to continue that virtual. I know as we start to kick off a lot of the Epic stuff, typically it would be an in-person. But we’re doing a lot more of it virtually and we’re seeing we get much better present participation from the organization because we are doing it virtually.

[00:35:51] You know, I think it it really drove home that customizing an application is not the best thing for [00:36:00] organizations to do. Because again, we were paralyzed during COVID and had to custom build everything because we had customized our environment so much. And just today we were talking to Epic about here’s all the different things that they were able to offer during COVID for people who had been aligned to that foundation system. So I think there were a lot of really good lessons learned that we may not have been as stringent on with the Epic implementation, if we hadn’t gone through COVID. 

[00:36:28] Bill Russell: [00:36:28] Well, I, you know, I’m looking [00:36:30] forward to seeing how things transpire for you guys.

[00:36:33] There’s an awful lot of exciting things that come with doing an EHR project and an awful lot of challenge, I guess, is the right one word. You know, having done, these before in three different States. It’s you know, there’s just a lot of conversations, a lot of moving parts and you know, it’s, an exciting time.

[00:36:52] It’s an exciting time for the team but there’s an awful lot of work ahead of you.  You know congratulations on moving forward. But you know, [00:37:00] I just, I have some empathy for what you’re going to be going through over the next couple of months as well. 

[00:37:05] Andrew Cooper: [00:37:05] Yeah. Well, I, you know, I appreciate that and I will say, you know a lot of the physicians that we would rather take the pain of doing an EHR conversion to know that it’s gonna set us up for long-term success. And I think we, as an organization were all very excited for this conversion. And so us as a team we will make it through as we always do. 

[00:37:25] Bill Russell: [00:37:25] Absolutely. Well, you know, good luck. I noticed you have black hair [00:37:30] and you know, you see mine’s all grey. So we’ll catch up with you again next year and you know, see that, you know, talk about the implementation, how it went. And some of the lessons learned. I think it will be a great conversation.

[00:37:42] Andrew Cooper: [00:37:42] Absolutely. 

[00:37:43] Bill Russell: [00:37:43] Well thank you, Andrew. Thanks for your time. 

[00:37:45]Andrew Cooper: [00:37:45] Thank you.

[00:37:46]Bill Russell: [00:37:46] What a great discussion. If you know someone that might benefit from our channel, from these kinds of discussions, please forward them a note, perhaps your team, your staff. I know if I were a CIO today, I would have every one of my team members listening to this show. It’s [00:38:00] conference level value every week. They can subscribe on our website thisweekhealth.com or they can go wherever you listen to podcasts, Apple, Google, Overcast, which is what I use, Spotify, Stitcher. You name it. We’re out there. They can find us. Go ahead. Subscribe today. Send a note to someone and have them subscribe as well. 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, StarBridge Advisers, Aruba and McAfee. [00:38:30] Thanks for listening. That’s all for now.

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