March 19, 2021

 – Episode #

379

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March 19, 2021: Atrium Health is at the forefront when it comes to mass vaccination. Becky Fox, Vice President, Chief Nursing Informatics Officer speaks to Bill live from the Bank of America stadium in Charlotte, North Carolina where they are vaccinating 14,000 people in one week. These events are very complex and it’s clear that the key to performing them smoothly is informatics. What’s involved in the planning? How do you schedule an event like this? What technology do you use? Who do you partner with? Are the vaccinations tracked in the EHR? Is there a special setup required to support that? And how do you educate your staff and manage them? The quicker we can get to the finish line, the more we can get back to the life events that we all look forward to.

Key Points:

  • Vaccination efforts are not for the weak [00:04:50] 
  • Patient portal – myatriumhealth.org [00:10:30] 
  • There’s a whole communication effort to ensure we are reaching underserved populations or those that might have challenges getting access to technology [00:11:20] 
  • It’s been really inspirational to see patients so appreciative and feeling like they have a new future ahead [00:13:40] 
  • Clinical informatics serves as the glue between the clinical world and the informatics world [00:30:45] 
  • Atrium Health 

Nursing Informatics and Its Role in Mass Vaccination with Becky Fox of Atrium Health

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Nursing Informatics and Its Role in Mass Vaccination with Becky Fox of Atrium Health

Episode 379: Transcript – March 19, 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.

Bill Russell: [00:00:00] [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 we have a great show for you. Becky Fox, the Chief Nursing Informatics Officer with Atrium Health joins us. She actually joins us from the mass vaccination event that they are doing in Charlotte, North Carolina. And she spills the beans. [00:00:30] She shares all the details, what they did leading up to it, how the events are going, what are some of the statistics and whatnot. So hopefully our community can learn from what they’re doing. I think you’ll love the show. 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]

[00:00:55] Just a quick note, before we get to our show, we launched a new podcast Today in Health IT. [00:01:00] 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 todayinhealthit.com. And now onto today’s show. 

[00:01:19] All right. Today we have Becky Fox, the Vice President and Chief Nursing Informatics Officer for Atrium Health. Joining us, actually joining us from a mass vaccination event. Good [00:01:30] afternoon, Becky. Welcome to the show. 

[00:01:31] Becky Fox: [00:01:31] Thanks Bill. Glad to be here with you 

[00:01:33] Bill Russell: [00:01:33] Well I’m looking forward to it. You’re actually at the vaccination event right now as we’re talking. 

[00:01:40] Becky Fox: [00:01:40] We’re holding a yeah, it’s a three-day event that we’re having back at the Bank of America stadium, which is a great place to be. It’s a sunny day in Charlotte, North Carolina.

[00:01:48] So everybody’s glad to come out here and get their first shot of hope. So we’ll be coming back here in three weeks and delivering the second dose but we’re going to vaccinate about 14,000 people today, or this week I should say. 

[00:02:00] [00:01:59] Bill Russell: [00:01:59] Wow. Well we’re going to, we’re going to dive into this cause I really want to understand what you guys have done and towards the tail end, I’m going to ask you a couple questions about nursing informatics.

[00:02:10] Cause we’re collecting all this information and I’ve had people tell me they want to hear about people’s roles and what they do. So I’m going to circle back to that. But Atrium, you guys have really been at the forefront of these mass vaccination events. You’ve or at least from the very get-go. I remember reading in [00:02:30] social media that you were doing it. You did the Charlotte motor Speedway. You’ve done the Bank of America center and others. Tell us about the events and what you have done to date. 

[00:02:43] Becky Fox: [00:02:43] Yeah. So Atrium health is very much committed to making an impact on the community.

[00:02:47] And we know that the best way to do that is to quickly get to herd immunity through a vaccination effort. So what we’ve done is, you know reached out to some great public private partnerships. So the Charlotte Motor [00:03:00] Speedway Temper sports and entertainment have really rose to the challenge and recognize that if we all work together collectively, then we can make a big difference.

[00:03:10] Honeywell has also been a great partner in that. And so together, all of us brought our great strengths, whether it’s healthcare, logistics, understanding really what a patient experience needs to be like, and then bringing all of that expertise together in very short order to deliver a mass vaccination event.

[00:03:27] So what we did was we started out, you know, very, [00:03:30] we went slow to go quick, meaning that we established the vaccination program. We rolled that out to our teammates. We then rolled that out to doing daily operations and drive through models. And then we recognize that the only way that we’ve got to get around this pandemic is to make a big, a big impact.

[00:03:46] And that was with mass vaccination efforts. And so the Charlotte Motor Speedway was the perfect place. You know, they know how to drive cars really fast. And so we knew that that would be a great location where we could drive a lot of cars through garages and vaccinate folks. Plus anytime [00:04:00] you get to drive on the Charlotte Motor Speedway track, that’s just a really cool experience.

[00:04:05] Bill Russell: [00:04:05] Wait, wait, wait, was there a speed limit? Did people have to go a certain 

[00:04:09] Becky Fox: [00:04:09] There were speed limits but it’s pretty, it was a pretty incredible experience because you got to drive on the track to come around to the first screening station. We would ask you a few questions, make sure that, you know your observation period was going to be appropriately timed, and then you got to drive around the other half of the track and then come into the garage. So it was pretty cool. I mean [00:04:30] you’re there to get vaccine and you get to drive on this Charlotte Motor Speedway. There’s no other better experience than that.

[00:04:36] Bill Russell: [00:04:36] No that is, that is amazing. Talk about the partnerships in a little bit more detail. So what kind of partnerships were important? I assume there’s a state partnership as well, because we have to get quantity of the vaccine for these events. 

[00:04:50] Becky Fox: [00:04:50] Yeah. You know, vaccination efforts are not for the weak. I mean, it’s really hard work. It’s, you know, I’ve worked in informatics for a long time. I’ve worked in healthcare for a long time [00:05:00] and that’s really complex things that we do. But when you add vaccines, working with the state, working with the federal level, and then recognizing that you’ve got to meet the demands of patients and have a great experience. And how do you pull all that together?

[00:05:13] Once you really have got to leverage your relationships and your partnerships. And those that are willing to come to the table and make great things happen. And so that’s exactly what happened. Our CEOs have good relationships and our friends. And so they they took a walk one day talking about how the pandemic had really [00:05:30] impacted all of their industries, whether it’s an entertainment industry, whether it’s a sporting industry or whether it’s a technology company.

[00:05:37] And of course, healthcare being in the middle of that, we recognize that if we all work together, that we can make you know, big things happen. And so that’s what happens. We had about, we had about seven days to plan the Charlotte Motor Speedway. We had another seven days to come to the Bank of America.

[00:05:50] And what we really wanted to do at Atrium Health was learn, you know, how do we make it a good experience? And then how do we leverage any of those learnings and continue to move it forward? So we did [00:06:00] the Charlotte Motor Speedway where there was a driving experience. And then the bank of America, we actually blocked some roads in Charlotte. We did a drive in experience and we also had a walk in experience because we know as every single state continues to make adjustments in the age requirements. So today we’re able to vaccinate essential workers. You know, you have to be able to accommodate that. You know, several weeks ago we were only vaccinating 75 years and older then it was 65 years and older.

[00:06:27] And so every time that those state [00:06:30] changes we have to make sure that we’ve got the right setting and the right venue to accommodate those things. And so even today when we returned back to Bank of America, we’re not doing any drive-through, it’s truly only a walk-in experience. And we’re trying some different staffing models at the same time, because again our opportunity is to learn really quickly.

[00:06:49] And so the event that we’re even holding today will be metamorphosized a little bit tomorrow and even further on Thursday. And our goal is always to make sure that it’s a great patient experience and more importantly, even [00:07:00] a great teammate experience and a great partnership experience. 

[00:07:03] Bill Russell: [00:07:03] So let’s talk about the planet. Let’s talk about the different decisions that have to be made the walking environment versus a driving environment. Driving creates that natural, you know, six foot separation, whereas walking is different. Do you work with your partners. Do your partners know how to move people in and out of their venues and you work with them on that? Or is it the kind of thing where you’re sort of consulting with each other? What does that look like? 

[00:07:28] Becky Fox: [00:07:28] We are consulting with [00:07:30] our, each other all the time. So you know, I was walking up here to this to come and talk with you right now. And so one of our partners at the Bank of America stadium stopped.

[00:07:39] And so we have a couple of touch points throughout the day. Understanding what is the queue line looking like? What is our hourly stats looking like? Are we staying ahead of schedule? Did the lunch breaks for our staff have an impact. Do we need to make any kind of adjustments. And even looking at things like no-show rates, you know, depending on the availability of vaccine in the world can really make a [00:08:00] difference with what if someone decides to come out and get their vaccine today. Even something as simple as the weather can make a difference.

[00:08:07] And so we are always constantly using data and technology behind the scenes to monitor that and then working with our partnerships and of course, putting our eyes on, you know, I’m looking out the window right now, so I can see the queue line. I know if a person hits that spot, it’s about a 20 minute wait for them to get from point a to point B and then we make adjustments accordingly.

[00:08:28] Bill Russell: [00:08:28] Yeah. Do you have any [00:08:30] statistics that you can share at this point? How many people have been vaccinated, timeframes that it takes for people to get through? 

[00:08:36] Becky Fox: [00:08:36] Yeah. So generally speaking, it’s about less than an hour for, and that’s, our goal is really to make it less than an hour to come in, get your, get checked into our system, get your vaccine, and then you have to go through either a 15 minute or a 30 minute observation.

[00:08:50] And that really depends on your past experiences. If you’ve had allergies to vaccines in the past or not, that will help guide us as to how long we observe you for. And so we’re really trying to [00:09:00] target the entire experience, taking less than an hour because you know, it’s a lot of people to get through in a short amount of time but we feel that, and that’s the feedback that we’d heard and talking to our patients is that they feel that, you know, between 30 minutes, 45 minutes or up to an hour, seems to be a reasonable timeframe to go ahead and get vaccine.

[00:09:18] I think a lot of people have also looked and seen stories across the United States where patients have waited four hours or six hours or slept in their car overnight. And that’s not the type of experience we want to [00:09:30] really bring to patients. We want to make sure that it’s a reasonable one to experience.

[00:09:32] And we’re really grateful for everyone, everyone’s patience. As we learn to do this. Together, you know, it’s not often that you’re trying to mass vaccinate, you know, hundreds of people an hour. So we really do appreciate everyone’s patience and understanding as we continue to refine our processes.

[00:09:48] And most importantly, hope to share these lessons and learn from others so that we can continue to all get better. 

[00:09:54] Bill Russell: [00:09:54] Yeah. And I appreciate you coming on the show and sharing some of your learnings from [00:10:00] this. Let’s let’s talk about a few things. Let’s focus in on a few things here.

[00:10:04] Scheduling, tracking, and messaging. So what were some of the challenges in scheduling? I mean, you said hey, we have seven days to plan the event. Well, I assume that’s from you know, start line to getting all the people scheduled, to getting everybody coordinated. There’s an awful lot of logistics to doing that, but how did you get the people in line? How did you get them scheduled and in queue? 

[00:10:27] Becky Fox: [00:10:27] So we have what we call a patient [00:10:30] portal. It’s a real easy way. You go to myatriumhealth.org, and you can enter some basic information about yourself. It’ll ask you a few questions and that validates that you are who you are. And then we have just a simple place on the screen where you can choose to schedule yourself for a vaccine.

[00:10:47] It will ask you a few qualifying questions. If you’re a certain age group or perhaps you’re a healthcare worker or a teacher or an essential worker now, and then once you answer those questions, it will let you go ahead and self-schedule. And then what [00:11:00] we do is when you schedule for their first appointment, you’re automatically scheduled for your second appointment, depending on the type of vaccine that `we have.

[00:11:07] So with get a Pfizer dose, then you’re automatically scheduled to come back in three weeks. If you’re getting Moderna, then you’re automatically scheduled to come back in four weeks. And so we go ahead and we put those scheduling tools out there and then let people self-schedule. And then of course there’s a whole communication effort that reaches out to certain populations, making sure that we’re hitting those that are underserved or [00:11:30] might have some challenges with getting access to technology. So we’re working with groups in the community to make sure that we can help those folks get signed up and easily scheduled for events. 

[00:11:40] Bill Russell: [00:11:40] Yeah and we can see the kind of marketing that Atrium does just over your shoulder there. I mean you’re one of the few people I’ve interviewed where the, you have the the screen just rifling through the different communication points for for the event today. It’s kind of fun. Fun to watch.

[00:11:59] Becky Fox: [00:11:59] Yeah it’s been [00:12:00] actually really meaningful to you you know, there are certain milestones, I’m sure we all remember key moments in your life. And this is somewhat one of them. Hopefully we never lived through a pandemic ever again but being here and hearing everyone’s held their stories.

[00:12:14] So you’ll see the screens shot that says, you know I got my shots, you know, and people were telling us their why as to why they’re getting their shot. And most importantly, what they’re looking forward to. I think those are the things that somewhat fuel all of our team behind the vaccination [00:12:30] efforts.

[00:12:30] I mean, like I said, it’s a lot of work that goes into this. A lot of people here on site at the Bank of America, but there’s a whole team of people behind the scenes from IT to security, to communications that are making things happen. And so, but the thing that keeps us all fueled and really passionate about trying to really ensure that our community is impacted in a positive way, is hearing the stories from the patients and hearing how important it is to their families.

[00:12:56] How, you know, grandparents are going to go see and visit their first grandchildren. I [00:13:00] mean there’s usually not a day that I don’t walk out with a few tears. My eyes are choked up because someone has a great story of very appreciative feedback from the community as well. You know we’ve often joked, you know, I said, I I’m being told, thank you at least a hundred times a day, which is a great. It’s hard to imagine going back and doing other work now that we’ve had such a great experience.

[00:13:23] And most importantly, I would say our teammates have walked out with happy hearts because you know, it’s been really rough taking care of COVID patients. [00:13:30] It’s been very challenging. So we actually have brought some of our clinicians from the ICU and on the frontline taking care of really challenging patients. And it’s been, we call it the failure tank program and it’s been really inspirational to them to hear patients appreciative and feel like they have a new future ahead. 

[00:13:48] Bill Russell: [00:13:48] You know, it’s I mean, the story of seeing your grandkids for the first time, that’s a phenomenal story. And I think of these high school kids who are seniors and they [00:14:00] are, you know, I think of the experience I had when I was a senior and those kinds of things. And I just, I was just on a call with with a woman who was just talking about how her, you know, her senior is not participating in the marching band and those kinds of things.

[00:14:15] And these are the kinds of things that this is going to enable the quicker we can get to the finish line here the more we can get back to to life, to the life events that we all look forward to. So I appreciate the work you guys are [00:14:30] doing. All right. I’m going to go back to details here.

[00:14:32] So do people have to be patients? So as I go to my atrium.org, I think is what you said. Do they have to be patients and they have to be in your EHR to go through that? Or is there, is there another? 

[00:14:44] Becky Fox: [00:14:44] Yeah they don’t actually, they can just simply put in some basic information about them. It’ll validate them by asking them a couple of questions.

[00:14:52] You know, what was your past address? Do you have a bank account and this, you know, and it’s really just to validate who they are and then they can just simply schedule, so [00:15:00] you don’t have to be a Patriot. Patient of atrium health, but we’d love to have you as a patient of Atrium Health but they can very easily sign up and get scheduled right away.

[00:15:09] And then another thing just to keep a note is, you know, things are constantly changing as the state of North Carolina gets more access to vaccine, they distribute that to us as well as other health systems. And so we are constantly changing what options that we have today. We have drive through opportunities where people can drive at many of our hospital [00:15:30] locations.

[00:15:30] We also do community outreach where we actually take vaccines to a particular church groups. And really partner with them to make sure that we can bring vaccine to those that are, might not have the same access as you or I to getting the vaccination. And so, and then there’s a couple other things that we’re doing, working with employers.

[00:15:47] And really, and then of course, like I said, the mass vaccination event, it just helps us get to big quantities of folks in a short time.

[00:15:56] Bill Russell: [00:15:56] Yeah so I mean that, that’s one of those questions I’m always wondering about [00:16:00] is. How are we going to get out there to the rural areas? So you guys cover a portion of North Carolina. You go down into South Carolina as well, right? 

[00:16:09] Becky Fox: [00:16:09] We’re in North Carolina, South Carolina and Georgia. And so we have a variety of things strategies. Wake Forest Baptist Health is one of our partners in our system and so what they’ve actually been doing is doing a really unique program where they actually take vaccine to patients that can’t leave their homes.

[00:16:23] So patients that are home bound, you know, they take a team, they take the vaccine out there. So which is great you [00:16:30] know, efforts to be able to bring vaccines specifically to people. We have another program that we’re in the middle of developing it’s called “vaccine to you” where same thing that we’re going to bring the vaccine to different locations and work with different employers who really have a great need, especially for essential workers.

[00:16:44] So there’s a lot of different strategies in development. None of them are always perfect. We’re always looking to improve those and refine those but we know that collectively, which with our state partnerships, our County partnerships, our health department partnerships, that’s how we’re going to be [00:17:00] able to make a big impact.

[00:17:01] Bill Russell: [00:17:01] Yeah. I mean, my point of your geography and the South in general is large cities with significant distance between that and the next city. And a fair number of people who live in between those that you have to take into account and to service. Is there I mean, mass vaccination events are great for  the cities. Is there the equivalent of that in the rural locations? Can you just do it at a hospital or a community center or [00:17:30] something to that are, or a church or those kinds of things? 

[00:17:34] Becky Fox: [00:17:34] You really need to be able to have a broad stroke if you want to make an impact to the community. You know, what we found is at the Charlotte Motor Speedway, again, with just less than a week to get the word out that we were going to do an event we found that we had folks coming for what from, well, you know, more than a hundred different counties that were coming over to the mass vaccination event.

[00:17:53] So several people drove many hours. Some people were from out of state. You know, but we were able to [00:18:00] accommodate a large number of people. We vaccinated about 16,000 folks at that event at the Charlotte Motor and at the Bank of America, just the following week, we were able to vaccinate about 20,000 folks.

[00:18:11] Which is great if people can, as you said, drive to the city or get mass transit and come to the city, which is a great opportunity. But that’s why. Atrium health has really committed to a variety of different strategies and taking the vaccine to communities. Just this last weekend, we hosted an event up in Cleveland, Cleveland County, and we [00:18:30] vaccinated about 6,500 community members up there.

[00:18:33] So being able to take vaccine to different locations, we’ve done events at Cabarrus County. We’ve done them in Union County and each one of these events is a little bit unique. The one in union County, we partnered with the health department there. They were really hosting the event and we brought clinical staff to help support it.

[00:18:49] Sometimes our partnerships mean that we actually share some of the vaccine allotments that we’ve had. And then sometimes we go to the County and we do the whole thing where we’re bringing both the vaccine and the [00:19:00] staff and really making the event happen. So it really just depends on what the needs are of the community, but we’re committed to making sure that  we’re really here to serve and the mission is really for all. 

[00:19:10] Bill Russell: [00:19:10] Yeah, I’m going to get back to the ITstuff I promise. But the, so is it more of a Pfizer strategy in the cities and a Moderna strategy in the rural areas? Is that happening? 

[00:19:23] Becky Fox: [00:19:23] I wish it was that simple. It’s not though because you know, it really depends on the allotments that we’re getting from [00:19:30] the state. And so the state of course, is doing their best that they can with the allotments that they get from the federal government. And so there’s a variety of different ways that we get different allotments and then how we’re using them. So for example, this coming weekend, we’re going to be holding another mass vaccination event at Johnson C Smith university.

[00:19:47] And this was really geared for teachers and that we’re going to be offering the Johnson and Johnson which is a one-time dose. So we’re really excited to bring that. But anytime you bring a different vaccine, there’s different management that goes with it. So for example, the Johnson and [00:20:00] Johnson once you draw it up into a syringe, you have two hours to use it as opposed to the Moderna and the Pfizer, where you have about six hours to use it.

[00:20:07] So it ha we have to change our staffing models to meet those needs and those demands of the type of vaccine. But what we aren’t necessarily gearing one type of vaccine for one rural area or a central city area. We’re really just trying to use up whatever vaccine that we have in the most appropriate way and in the quickest way that we can to get to that herd immunity

[00:20:28] Bill Russell: [00:20:28] Wow. All right. So IT. [00:20:30] This show is This Week in Health IT. So I have to get back to that. Do you track the vaccinations in the EHR? 

[00:20:37] Becky Fox: [00:20:37] Well it depends on what you mean. We have a lot of informatics behind the scenes of all of that. And I, of course, I live in the world of informatics. So this is what I think has made us successful. Is making sure that we have clinicians who can understand the entire workflow that also have a foundation in informatics to help drive and make sure that all of the technology works out in a really seamless way.

[00:20:59] So [00:21:00] and our partnership with Honeywell, they actually helped us develop some screening technology. And so, and the patients come into the health system, they check in, I’ll pull up a screenshot real quick and show it to you. But the patients check into the system and then what they do is they answer a few questions. They get a text actually the night before. They answer a few questions and then they get a code. So it looks similar to this where you get this onto your screen. This QR code of course helps identify the patients. So when we get them [00:21:30] in and we’re ready to vaccinate them, the clinician can scan the QR code. It pulls them up into our EMR. 

[00:21:36] We actually use some barcoding technology to quickly document the very comprehensive details about the medication. And then so that’s another piece of technology that we’ve put in place. And then there’s also a timer on the bottom of this tool. And so that timer starts to countdown. So the moment you get your shot, you hit the button and now it counts down. So it’s to help our patients move along and know how much time they [00:22:00] have left. We were kind of laughing at the next, at the last event that we just had because in the drive-thru we had our patients that were using that timer.

[00:22:07] And so one of our clinicians was going up to a car and saying, Hey, you need to go ahead. It’s time for you to leave. And the patient’s like, now I have 15 seconds left or like, okay, wait for your, wait your 15 seconds. That’s great. But it’s these little pieces of technology that help make the whole process faster.

[00:22:24] So whether it’s checking in, screening the patient, documenting medication or [00:22:30] timing the patient and observation, we want to make that whole thing really seamless and the best way to do it is to have clinical informaticist. informaticist’s involved in the planning and the strategy and that way you’ll, you’ll walk out with a good process and plan.

[00:22:43] And that’s what we’ve heard, when we’ve talked to other sites across the United States and around the world that are doing mass vaccinations is informatics is key in order to make it all run really smooth. 

[00:22:54] Bill Russell: [00:22:54] How much of this experience do you think you’re going to take back into, let’s say we’re post COVID you’re [00:23:00] going back into the clinical setting and into the hospital setting. Are there things you’ve picked up as a result of this process that you’re saying, Hey, going forward, we’re gonna, we’re gonna incorporate some of this. 

[00:23:11] Becky Fox: [00:23:11] There are, I mean, like I said the documentation piece, so I’m a nurse by background. So the documentation of the vaccine of any vaccine is a little bit cumbersome. You have to put in an NDC code. I think it’s about 11 digit code. You have to put in a lot number. You have to put in a manufacturer. You know, there’s [00:23:30] about nine different fields of information. And so what we recognized, if we’re going to do this on a mass scale we’ve got to be able to do it very quickly.

[00:23:37] And so we created a multi field barcode. Every day we changed that because our lot number might change on the type of drug that we’re using that day. And so we created this process as well as the technology. So now instead of it taking about 60 seconds to document something it takes about two seconds for the nurse to document.

[00:23:53] So, you know, shaving, you know, you’re from informatics, you know, shaving off a minute times [00:24:00] 20,000 patients is pretty, pretty substantial. And I can tell you, it also gives it a better experience for your clinician. So, you know, as you can imagine, it’s one thing to just document that on one or two patients, maybe 10 patients a day when we’re doing documenting that on hundreds of patients every single hour it can be really tiring. Especially if I say, Hey, you’re going to do it outside where it’s 32 degrees and then you have goggles on, you can’t see the screen. All of those things make an impact. 

[00:24:28] And so this technology is really [00:24:30] key to making sure that the process continues to run smoothly. So the thing that we’re going to take back from this COVID is somewhat changed our culture of the world, where we need things to be changed instantly.

[00:24:40] So, you know we joke now, you know, we used to take these long cycle times of like, oh, we’re going to pilot that for six weeks and then we’ll get back feedback from the customer for another two weeks. And now we’re in the process of, we do it in hours which is, it’s good and yet it’s it’s exciting in a [00:25:00] lot of ways too but literally we just made, for example, a changed this app, we just changed it last night.

[00:25:05] I was just texting with one of our team leads, who was asking me for feedback. They’re going to go back and make those changes. And then by tomorrow morning, we’ll probably have some different things in there. But we all understand that we’ve got to continue to be iterative in our technology design and really listen to our clinicians who are using it and then make these adjustments and move forward.

[00:25:24] Bill Russell: [00:25:24] I’m going to head into nurse informatics route here in a second, but is there any question I didn’t ask [00:25:30] that you think the community would benefit from really understanding about the lessons learned or just any aspect of it? 

[00:25:39] Becky Fox: [00:25:39] I think just really understanding of what a complex process it is. Everything from getting the vaccine, when you get it on site, being able to store it in a freezer, being able to make sure it gets to the right place.

[00:25:50] How do you educate your staff and then how you manage it? Even at an event. So for example, today, you know, we’re going to vaccinate about 4,600 people, but if [00:26:00] 5% or 10% don’t show up, that’s quite a substantial number of patients. And so understand that there is, it is a, quite a complex process because you have to figure out if you didn’t use it on Tuesday, it might still be in the refrigerator and safe where we don’t throw it. You know, our mantra is we don’t waste vaccines. But you still have to make those adjustments and plan and your schedule and your operations later on in the week. And so I just share with everybody, like it is a really complex process. And so if you know [00:26:30] anybody that’s out there working in vaccines be extra nice to them because it’s not for wimps. That’s for sure. There’s lots of long hours and sleepless nights and weekends that people are putting into it. And but we know that if we all work that way, that we’re going to make a difference. 

[00:26:47] Bill Russell: [00:26:47] Well you know, it’s interesting, we’re entering a different time. And if the you know, if the stories and things are accurate, I mean, you have Merck and J and J working together on production of the single [00:27:00] shot vaccine and you still have Madonna and the Pfizer vaccine, we should have a significant supply.

[00:27:06] I mean, in theory, we should have a significant supply within the next month or so in which case does it change the strategy at all, do you think or is it still a similar strategy going forward? 

[00:27:21] Becky Fox: [00:27:21] It does change it. And so that’s why it’s been really important for us to kind of run hard and fast at something to learn all that we can.

[00:27:29] So, you [00:27:30] know, I know many of my friends and colleagues have said, you’re crazy. Why would you ever try to do back-to-back mass vaccination events? But we really needed to do that to say, well, what can we do? What is the staffing requirements for that? What is the technology requirements for that?

[00:27:46] And then how do we, what do we look to as what we call a midterm or a longer range plan and strategy. So you have to learn those things really quickly make pivots and adjustments, and now we know what we can do for it. So for example, [00:28:00] At the Charlotte Motor Speedway, we’ve accelerated about 5,000 patients at a day.

[00:28:04] And this was back in long time ago in January. And so, you know, that felt like, you know, going into that week, we said, Oh my gosh, 5,000 patients a day, we’re never going to be able to do it. It’s going to be really hard. But by the time we came back for our second appointment, you know, our second timeframe just a few weeks later, we said, oh my gosh, we’re so bored.

[00:28:23] I mean, that’s what the, our staff member said that they were like, we could have done so many more. And that was because, you know, just in those few weeks we [00:28:30] had really refined processes. We had teammates that had now done this several times. And so it’s really important to kind of figure out how you can go faster.

[00:28:38] So now, if we would ever go back to Bank of America, I mean the Charlotte Motor Speedway, we would double that, you know, we would double that volume. We tried to figure out how do we triple that volume? And again, you know, we can’t do that if we don’t have vaccine supply. So vaccine supply has been our big limiting factor.

[00:28:53] And now that we’ve had these lessons learned, I think that you’re going to see many places around the United States that the, instead of doing a thousand a day, they’re going to [00:29:00] do 3000 today. Instead of 3000 that are going to do 5,000 and then we’ll all see about mass vaccination events. If they’ll even be needed, if you can do and take your daily operations and expand that up. 

[00:29:10] Bill Russell: [00:29:10] All right, Becky, I’m going to put you on the spot here. So we w we actually have a fair number of people who are in college and master’s programs and whatnot, who are listening to the show based on our surveys and whatnot. And so you’re gonna be talking to the next generation at this point. So some basic questions, basic to us but [00:29:30] I think to them would be interesting. Yeah. What is nursing informatics and why? Why is it important? 

[00:29:36] Becky Fox: [00:29:36] So number one, nurses make up the largest sector of healthcare workers in the United States and around the world. So we have more than 4.7 million nurses. Number two nurses are the most trusted profession in healthcare for like the third year running.

[00:29:51] And I mean, it’s just, it’s an important aspect to understand that clinical workflow and to see how you can optimize it. Make it [00:30:00] better, bring technology into it. And so that’s my role. I’m the Chief Nursing Informatics officer. And so my role is to set how help to set strategy and vision of how our clinicians use technology so they can be better at what they do.

[00:30:12] So the nurse at the bedside is better at being at the bedside with the patient. If her phone could do medication scanning. If she can talk to the other clinicians via texting, if she can very quickly do documentation and not have to spend hours and hours and hours doing a routine things in a computer.

[00:30:30] [00:30:30] And so that’s my role, is to help them make it smoother, bring the technology at the right place at the right time. So that that way the nurse has a great experience. All clinicians have a great experience. And then most importantly, that the patient and the consumer have a great experience. So clinical informatics is really important. It serves as the glue between the clinical world and the informatics world. So many times I’m translating to my IT colleagues, you know, who say, well, I don’t understand. Just put it on the phone. And I’m like, well, it doesn’t really work that way because this is the [00:31:00] workflow. And at the same time you know, I have clinicians that are like, why can’t IT just make it like this? And I’m like, well, because there’s, you know, all these interfaces that need to go on the backend.

[00:31:09] So we really serve, you know, my team and I, we serve as the great translators where we say, this is what we think you can do. So we explained to IT some of the clinical needs and the business needs, and then we helped explain to the clinicians how and why they need to adopt things.

[00:31:25] You know, sometimes it’s hard to get clinicians to say, like, this is you gotta take care [00:31:30] of patients differently. This is how we’re going to help, you know, get you there and improve these things. But what we find is if you bring everybody together and understand both worlds, then you can, you can make bigger things happen.

[00:31:39] And that’s why it’s important to have clinical informaticists in any of the work that we’re doing in healthcare. 

[00:31:44] Bill Russell: [00:31:44] This is going to sound like a silly question, given all the things that you just talked about, but how is nursing informatics changing and how will it change in the future? And what’s causing it to change if it is changing. 

[00:31:57] Becky Fox: [00:31:57] Well I think what everyone’s seen is the [00:32:00] value that clinical informatics can bring to the table. And rather in your strategy for your healthcare system, in your financial aspect. And of course in any business you know, business plans that you have. Again you know, every hospital has a lot of clinicians and the number one group of clinicians that they have is nursing.

[00:32:19] And so if you’re not optimizing them, if you’re not helping them be better at their job, then you’re missing out on an opportunity. And that’s what we’ve seen over the last probably 15, 20 years is there is a trend to develop the [00:32:30] position of Chief Nursing Informatics Officer, and to make sure that it’s recognized at a chief level.

[00:32:35] So I sit at the table with the CIO, the CMIO sometimes organizations will have chief clinical informatics officers, all of them with a viewpoint of how do we make workflows better for clinicians. So even though my title says nursing, my viewpoint is very much on how do I make things better for the pharmacist, the medical staff the students, the respiratory therapist, all of the clinicians because we’re all working [00:33:00] together. No one’s working in silos. And so you have to understand all of those components. And so there’s a big proponent of how do you really leverage a clinical informaticist to do that.

[00:33:10] And then when you do that, then you bring value again, back to the organization, whether that’s through streamlining and offering efficiencies impacting your bottom line of financial aspects. And then of course, making sure you’re strategically set up for the next phase of what you’re going to do in the future.

[00:33:27] Bill Russell: [00:33:27] Yeah that’s fantastic. My next question was going to [00:33:30] be, how do you interact with the other leaders and you pretty much address that because that is such a central part of the role. To be able to interact on the technology side, to be able to interact on the the CMIO side as well. And to have that, that group sitting together and working the same strategy, rowing in the same direction is so helpful. And I realize also that it’s very complex. You know, I’ve sat at those tables. It’s [00:34:00] very complex. It’s not always cut and dry. Like hey, we should do this. And everyone looks at and goes, yeah, that’s what we should do. Cause there’s competing you know, there’s competing priorities and competing things that you have to weigh, but if that team’s together generally it tends to go better.

[00:34:17] Becky Fox: [00:34:17] Yeah, so we also found, and I’m very fortunate, I work at a great organization where we do have a CIO, a CMIO and I work with a whole team of Chief Nursing executives that are very much [00:34:30] understanding of IT technology wanting to make things better. And when you have everyone at the table, really, as you said, rowing in the same direction, then that’s when you can really leverage things and just make a bigger impact.

[00:34:44] Bill Russell: [00:34:44] Well Becky, thank you for taking the time. This is, this has been a phenomenal discussion. I learned a ton and that’s how I judge whether these are phenomenal discussion is whether I learned a ton and you guys are doing some great work down there, and I really appreciate all the work that you guys are doing.

[00:35:00] [00:35:00] Becky Fox: [00:35:00] Really appreciate the opportunity to speak with you. I hope you, and all of the folks watching decide to go and get vaccinated. And if so, maybe we’ll see you at one of our future events. 

[00:35:08] Bill Russell: [00:35:08] Well if you’re going to let me drive on the Motor Speedway, I’ll bring my car up there but I have to be able to go faster than, if you put up a little five mile an hour sign, that’s going to be, you know, a little.

[00:35:18] Becky Fox: [00:35:18] Trust me, I know it’s tempting, but but the Charlotte Motor Speedway is a great place to go. Bank of America is another great place to be. We did get to let people go out and see the inside of the bowl. So if you’ve never been to the Panther [00:35:30] stadium and you see, walk in and you see all that, you know, Carolina Panther blue, it’s pretty awesome.

[00:35:34] So, and it just makes people feel better to go and have these cool experiences. So anyone out there that can you know, have a vaccination event at a cool venue, you should definitely do it. 

[00:35:43] Bill Russell: [00:35:43] Fantastic. Thanks again, Becky. Appreciate your time. 

[00:35:46] Becky Fox: [00:35:46] All right, you have a great day. Thanks Bill.

[00:35:48]Bill Russell: [00:35:48] 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 [00:36:00] every one of my team members listening to this show. It’s 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, [00:36:30] Aruba and McAfee. Thanks for listening. That’s all for now.

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