December 11, 2020

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December 11, 2020: Reactions during COVID were critical and time sensitive. Marty Paslick, CIO for HCA Healthcare shares his health systems response. How did the CIO role shift during this time? What were you being asked to do as a technology leader? Which projects did you halt or severely slow down? What were the critical things that you pivoted toward? If your system experienced different speeds of COVID in different areas do you still make a one size fits all solution? How did you keep the connection between patients and their families? Is your clinical data warehouse sophisticated enough to make accurate predictions? Finally, how did we become so fast at everything?

Key Points:

  • HCA is set up in 14 domestic US divisions today and each of those divisions have a CIO [00:04:21] 
  • Once HCA gets either a workflow or a technology working here it’s pretty much industry ready [00:06:40] 
  • One of the critical things we needed to pivot toward, early on was laboratory interfaces [00:08:55] 
  • Rediscover your inner operator [00:11:17] 
  • During COVID hospitals across the country went to a no visitor policy so we had to quickly pivot towards how do we get a connection between patients and their families? [00:12:50] 
  • In the case of  what we were doing in the ICU, WebEx was a critical component [00:20:20] 
  • HCA Healthcare

Supporting HCA Healthcare’s COVID-19 Response with Technology

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Supporting HCA Healthcare’s COVID-19 Response with Technology with Marty Paslick CIO

Episode 340: Transcript – December 11, 2020

This transcription is provided by artificial intelligence. We believe in technology but understand that even the smartest robots can sometimes get speech recognition wrong.

[00:00:00] Bill Russell: [00:00:00] Welcome to This Week in health IT influence where we discuss the influence of technology on health with the people who are making it happen today. Marty Paslick the CIO for HCA Healthcare joins us, and we have a really great conversation. We cover so much ground. It’s really amazing. And I think you’re going to really enjoy it.

[00:00:21] My name is Bill Russell, former healthcare CIO, CIO, coach consultant and creator of This Week in Health. It, as we approach 250,000 downloads for [00:00:30] the year, I want to thank Sirius Healthcare for supporting the mission of our show to develop the next generation of health leaders, their weekly support of the show and our channel sponsors as well, has allowed us to expand and develop our services to the community. And for that, we are incredibly grateful. Now onto our show. 

[00:00:49] All right. Today, we have Marty Paslick the CIO for HCA healthcare with us. Good morning, Marty. And welcome to the show. 

[00:00:55] Marty Paslick: [00:00:55] Good morning. Good to be with you Bill. 

[00:00:58] Bill Russell: [00:00:58] Wow. I, you know, I’m excited to have this [00:01:00] conversation. This is actually the first time that, that you and I have met. We’re going to cover a lot of ground, but before we do, I want to give you the chance to really tell us a little bit about HCA healthcare. I’m sure everybody has an idea of what it is but give us an idea of HCA and your role at HCA. 

[00:01:17] Marty Paslick: [00:01:17] Sure. my pleasure. Well our company was founded, more than 50 years ago and there was a trio of founders. And two of those founders were physicians, [00:01:30] Dr. Fritz Sr and Dr. Fritz Jr. And they had the vision of 50, almost 51 years ago that they wanted to create, a health system that really emphasized high quality and high efficiency. And so that began the journey of our company. And today I would tell you that but the mission of the company is, is, is pretty important to us. Matter of fact, I can almost see the sign up above my, my [00:02:00] desk, over there. And, and we just really feel compelled to the mission statement, which is above all else. We’re committed to the care and improvement of human life.

[00:02:12] And some companies, feel like they have to create a mission statement as a check mark or just, I gotta do this sort of thing, but I would just tell you that at HCA it’s much more than that. And, got colleges that have [00:02:30] that little phrase that connect, people who support it, like Auburn has war Eagle or Alabama has roll tide.

[00:02:37] Well, I would tell you, inside of HCA, If one person says to the other above all else, they don’t have to receive the rest of the mission statement. It’s just an automatic, connection to who we are and what we try to do. And that’s why, we have, we have nearly 6,000 it [00:03:00] professionals in the organization.

[00:03:02] But I would tell you that they would, they would tell you that they would be, they would prefer to be called a healthcare professional first, before being called an it professional. And so,  the basics about HCA, we have more than 2000 sites of care, across the U S sets up, includes 187 hospitals. We are in 21 [00:03:30] States. and then I guess, for me personally, I’ve been the CIO for HCA for, since 2012. And I have been with the company, 35 years. I started as a software developer, for the organization and I would tell you, I’m not unusual. the senior leadership team is made up a lot  of high tenured  individuals who all started [00:04:00] as individual contributors of the organization. And so that’s a unique trait. I think about our organization. that kind of sets us apart. 

[00:04:10] Bill Russell: [00:04:10] Just out of curiosity. so your, your CIO for ACA, the entire system, cause we’ve, we’ve seen you have some, some regional CIO, is that right?

[00:04:21] Marty Paslick: [00:04:21] That’s correct. So we were set up in 14 domestic, US divisions today and each of [00:04:30] those divisions have a CIO. That reports back up through the organization. To me, we also have CEO’s that are focused on very specific components of the company. So, for instance, Parallon that does our business operations has a CIO health trust that handles our supply chain logistics and our group purchasing organization has a CIO.

[00:04:57] Sarah Cannon research Institute, [00:05:00] also has a CIO and then we have about 4,500, 5,000 employed physicians along with urgent care, that are, on that organization called physician services group also has a CIO as well. 

[00:05:15] Bill Russell: [00:05:15] So you have to be thinking, I mean, the thing that’s distinct about HCA has to be scale. Everything you do you have to start with the idea of. Yeah, we can do it for this one entity, but we’ve got to think a much larger organization I would imagine. 

[00:05:30] [00:05:30] Marty Paslick: [00:05:30] No, absolutely. I mean, I think that, especially when we work with small innovative companies, it’s one thing that we can bring to the table. Honestly, they might be bringing a great idea or a great concept but what the organization is looking to us to do is, is, hey, make sure that thing will scale across the organization.

[00:05:52] Bill Russell: [00:05:52] Yeah. And that’s when you’re a small organization and you’re hooking up with HCA, you got to think we got this big deal and then you get in and you [00:06:00] realize, Oh my gosh, this is, this is huge. I would imagine those startup entrepreneurs go through the range of emotions after they, after they get going. 

[00:06:09] Marty Paslick: [00:06:09] when we, when we first started, when we first started to build our, and we’ll talk, I think we’ll talk about today about data, our clinical data warehouse we had a vendor working with us and we were in a meeting one day and they were struggling a little bit. And I don’t think, I don’t think the representative knew what they were saying in front of us, but she [00:06:30] finally just stopped and said, we just realized that you guys are really, really big. And, and, it was an accurate statement. So, so it is, it’s always a challenge, but I, I will say once we get either a workflow or a technology working here, it’s pretty much industry ready. That’s for sure. 

[00:06:51] Bill Russell: [00:06:51] Yeah, it’s better. So we didn’t, we didn’t really get the opportunity. We did a COVID series, in the, in probably April May timeframe and we didn’t get a chance to talk. [00:07:00] And I want to walk through some of that with you because, an awful lot happened in early 2020, it’s still going on today, but I specifically want to go back to early on in the, in the pandemic. Give us an idea of, of how your, how your role shifted and what were some of the things you were being asked to do as a technology leader during that time?

[00:07:24] Marty Paslick: [00:07:24] Wow. it’s it, on one hand, it seems so long ago. And on another [00:07:30] hand it seems like it was just yesterday. Everything changed and I’m sure, all the other CEOs and other technology leaders you’ve talked to basically say the same thing. For me personally, you get to, to a place in the organization, especially when like ours is so large that your role is primarily that of a consultant. You’re consulting with people, you’re providing them your years of experience or knowledge. You’re helping [00:08:00] them with decisions. And then, all of a sudden, and really almost that quick you walk into your office and your schedule has disappeared. It’s gone. There is no governance meetings to go to.

[00:08:15] There are no other types of activities. And for me, at least personally, I rediscovered the operator inside of me. And, so we had to take some fast action. we, we had, [00:08:30] operational impact, clinical impact, technological impact. So the first thing we did, was we halted more than 375 projects, halted or severely slowed them down.

[00:08:44] And we pivoted, to sit down with our operators, sit with our clinical operations group and really try to understand what were the critical things that we needed to pivot toward, [00:09:00] early on you would say, laboratory interfaces. So we were quickly negotiating with a reference labs and we needed to construct those lab interfaces overnight. And, and I think, and as for my role, it turned out that, that I always tried to emphasize a flat operating model, even though with 6,000 people, we just talked about the CIOs, there’s a hierarchy. [00:09:30] Right. But operationally. I wanted to, to have a, a flat operational model. Well, during COVID, it became as flat as flat can be because we just all became colleagues.

[00:09:44] And with the collaboration tools like WebEx teams, we were just kind of all in there together. I’ll give you, I’ll give you a great example in those early weeks. We were, trying to build these interfaces to these reference labs. [00:10:00] And I’m a part of each of these, a WebEx team rooms, and one of our, integration analyst, just us, out, out in the open, of the room just said, Hey, Hey Marty, we, we need you to contact the CEO of this reference lab. They are telling us, this is a Friday PM. He said their technical staff is telling us that they’ll catch, they’ll get, get back on this on Monday morning. And that is not going to [00:10:30] work. And, and, and I, I called her CEO and said, look, god, I, I don’t want to be an overdramatic year, but lives are at stake here.

[00:10:41] And we need to process these labs as fast as we can, as soon as we can. And we’re ready to work. We’re ready to work through the weekend, do whatever we need to, but we need you to get your staff to help us. And sure enough, the CEO turned to his team and early the next week we had those, those [00:11:00] interfaces up and running. And so for me, I became an operator again and, and I think that goes for everybody in our company. I, it doesn’t matter what your role was all of a sudden you were very hands-on as far as our response goes 

[00:11:17] Bill Russell: [00:11:17] Rediscovered your inner operator. That’s a great, great quote. They didn’t have to go back and start programming again, though, right? So you didn’t go that far back? 

[00:11:26] Marty Paslick: [00:11:26] No, the developers, whenever I try to give them advice on [00:11:30] software development, I get the rolling eyes pretty, pretty fast. 

[00:11:35] Bill Russell: [00:11:35] It’s interesting cause you guys have such , again, I can just go to scale your, this, this pandemic was not experienced like we thought originally we thought it was just going to spread all the way across the country and it turned out to be really a local impact.

[00:11:49] Well, it just, it sort of manifested itself, significantly in New York, significantly in new Orleans, Seattle, some, some [00:12:00] locations, but in other locations, we saw a very slow ramp up. Now it’s ramped up in a lot of places today here in December, but, but early on, I mean, did that create some challenges for you in terms of just how it was being experienced unevenly across your system?

[00:12:16] Marty Paslick: [00:12:16] Well, not, so you’re absolutely correct that, that COVID strikes in different, degrees, but we’ve have seen across almost all of our markets, 21 [00:12:30] States, the ebbs and flows of, of COVID. So when it gets back to the technology part and the things that we had to do, It really didn’t matter about whether or not it was a surge or not. I’ll give you a great example, regardless of where you were, hospitals across the country went to a no visitor policy, like rightfully so and so, So we had to quickly pivot toward how do we, how do we [00:13:00] get a connection between, patients and their families? And, and so it just, it, in a case like that, it just, it just didn’t really matter.

[00:13:11] And then when you, when you think about PUIs, you people under investigation, without having that and not without having a good lab turnaround time, No, the POI is we’re having to be treated just like COVID patients. And so some of the forces, even though we didn’t [00:13:30] experience a New York per se, some of the things that we had to do were still critical and still time sensitive.

[00:13:37] Bill Russell: [00:13:37] So let’s talk about some of those digital projects and specifically around video, telehealth type, technologies and those kinds of things. What, so you talked about bringing patients and their families together. What  kind of projects, what did that look like from a technology perspective and then from a rollout perspective for you guys?

[00:13:57] Marty Paslick: [00:13:57] Well, we were really fortunate to, to tell you the truth [00:14:00] because we had some great foundations. So we. before COVID we already had a great telehealth foundation. We had more than a thousand programs that focused on things like rural outreach, neuro, stroke identification, behavioral health assessments. So we had a very solid understanding of telehealth and we were actually executing it [00:14:30] quite well in a very decentralized way across the health system. But as health systems, had some new use cases that amplified really fast. So I mentioned one of them and that is, we went from, we went to a no visitor policy.

[00:14:46] And so now when he did, we have to figure out how to get the equipment iPads or whatever into our ICU or med surge rooms, but we had [00:15:00] to train people. We had to, get it all running basically. And so we had, we had Apple was a great partner. We’re one of the largest iOS users in the industry but we told them to have enough devices. So we literally had tech analysts walking through administrative offices, grabbing whatever iPad they could going into [00:15:30] patients’ rooms. And I’m not kidding. You. literally duct taping the iPads to IV poles and, and it was important, it was important to create the connection between the patient and their loved ones.

[00:15:48] And honestly, it created a better connection. Between our care teams and the families instead of, of a voice call. So that one in [00:16:00] particular was pretty, pretty important to us. The other foundational thing that we had going for us was that we, went down a path a few years ago that we wanted to go mobile. And we wanted to supply, our caregivers with a communication platform that we can not only use for voice if needed, but also use for texting and come COVID for the video [00:16:30] capabilities as well. So we have about 80,000 iPhones that are distributed across the company that we, that we actually, used for mostly of the text messaging, but gave us that great foundation in order to  operate.

[00:16:50] Actually, if you look at 2020, which is really the COVID year up to December 1st, that platform executed almost 170 [00:17:00] million text messages. And if you think about the speed in which something like that happens, is pretty important. The other big use case which we actually had work, done in, it was, it was really the, idea of the physician to patient connection, right? Maybe we had some of that activity occurring in  our hospitals before but we saw this rapid increase in use by our [00:17:30] physicians. We went from, I think, I think 2019 we had about, 3000 physician to patient interactions 3000 in 2019. And so far in 2020, we have had 800,000.

[00:17:50] And so the good news is we had the technology in place we had to, to make sure the workflow  was, Was efficient. [00:18:00] But, as you can tell, we went from, a very low number of physician to patient interactions. Say like you’re a family, family doctor to, nearly a million of video, Telecare cases.

[00:18:15] Bill Russell: [00:18:15] That, those are some staggering and amazing numbers. I’m curious, I want to ask some sort of a following question about standards, right? So you have those regions, you have those different entities. Do you [00:18:30] require the same solution across the entire enterprise? Or do you just, or do you allow some leeway in the time of a pandemic to say, look we’re not, we’re not going to be as stringent on standards. Let’s get the solutions in place. And then we come back to it later. 

[00:18:46] Marty Paslick: [00:18:46] Well, like I said, I thought we had, we had a good, we had a really good footprint. I mean, we had, we, we used one touch a lot across the organization and that became the kind of the primary, tool. But [00:19:00] to your point, some vendors. do dictate, the tool within their system. So we use e-clinical works for our, physicians are employed physicians. And so obviously we’re leveraging their technology within their platform. So there, there might’ve been a variation across the enterprise. But the use cases were fairly standardized.

[00:19:23] I had this and we use for the ICU case we use primarily right WebEx and we’re a, Cisco [00:19:30] was a great partner, through all that activity. And I had the chance to speak to one of their customer advisory boards. And I said, I think everybody looks at WebEx from a COVID perspective and go, wow, look at all the meetings and sure enough, we, we use it for a lot of meetings as well, but the one thing I wanted to emphasize too, to not only other customers to WebEx, but to do the engineers at Cisco was, Hey, your technology was one of the most [00:20:00] critical means for a patient that might for the last time talk to their family and, And I don’t think sometimes we as technologists.

[00:20:11] Ever come to grips with really how close we are to a patient. And in the case of  what we were doing in the ICU is WebEx was a critical component. So overall I would say very standardized in use cases, but different, [00:20:30] tools used based on, the use case itself. 

[00:20:34] Bill Russell: [00:20:34] So you also utilized the Microsoft COVID 19 chatbot self-assessment tool that was out there? Hows that working for HCA and, where can you imagine that technology going next?

[00:20:47] Marty Paslick: [00:20:47] That it was just amazing to tell you the truth? Is that what a great partner, Microsoft was. They, they had contacted us and said, look, We’ve we’ve, we’ve spent some time with some, [00:21:00] our engineering. We believe we have some technology that we think can help. Can we help you basically? And, we’re a good partners with Microsoft already, and we said, sure, let’s do this.

[00:21:12] This is just, I can’t even, again, it’s all about COVID speed. Right. But from the point we said, Hey, let’s do this. Till the point we headed operational was just a few weeks. It was, it was two to three weeks and it was operational across the enterprise. And I would [00:21:30] just tell you from a patient’s perspective, their alternative before that was to have the internet Googling and things like that.

[00:21:38] Or it was calling our contact center and our contact center was doing its very best to keep up, but you can imagine there was quite the volume of calls that were coming in and here, all of a sudden we had a very structured, a workflow that delivered great information to the patient. And it also provided guides at the end, [00:22:00] you should go here or you should do this. And so from a patient’s perspective, it was fantastic. And then from a contact center perspective, it allowed our contact centers to focus on other types of activities during the COVID surgeons. 

[00:22:17] Bill Russell: [00:22:17] Do you think there was, so what’s the follow on, I’m asking you to put on your chief digital officer and say, Hey, that was a pretty successful pilot if you will of a full scale production pilot but where does it [00:22:30] go next? 

[00:22:31] Marty Paslick: [00:22:31] Well, I, I mean, I, I think I speak for any healthcare system that you would talk to that, when it comes to bots and comes to automated workflows, we’re all just at the we’re in the early innings of these things, but I guarantee you, whoever you talk to is doubling down in that space right now.

[00:22:52] I mean, the one thing I would say about our patients he’s a really during COVID and post COVID, there are [00:23:00] two things they really want. Obviously they want quality care, but inside of that umbrella of quality care, they want convenience and they want to have confidence. And I really do believe these digital, bods and the digital patient journey. If we’re able to digitize more and more of, of what the patient needs to achieve, those two things. And we’re going to have a better experience. 

[00:23:26] Bill Russell: [00:23:26] Yeah. And that’s, that’s huge. I, I do want to delve into, [00:23:30] data and information or really data. During COVID, we’ve heard stories of, people’s standing up dashboards and record time and, and just the different information that was required, the information that had to be sent to the States put into registries, give us, I mean, that’s what, this is going to be a huge question, but give us an idea of some of the work that you did around data and around visualizing [00:24:00] the information for the caregivers and for the executives. 

[00:24:05] Marty Paslick: [00:24:05] Well, we were this a little bit of, a little bit of a history lesson, but, more than a decade ago, we made the decision as a company that we would, create our own standalone clinical data warehouse that not only included EHR data, but included any other data that we wanted to assemble together in order to get those kinds of insights.

[00:24:30] [00:24:30] You may have heard some of my colleagues in different other settings refer to our company as a learning health system. And it really does start with the clinical data warehouse, where we have nearly a 45 million patients in that data warehouse, over 150 million encounters, we track more than 4,000 unique data elements, for the patients.

[00:24:55] So that’s that foundation, is, is the, is [00:25:00] the, is the table stakes. And so going into COVID, we were already very fortunate to have just a, an unbelievable set of data to start with. Now, when you have that, you gotta have somebody or some team that can leverage it. And the other thing that HCA is very fortunate in and all their health systems as well have jumped into the data science space, but we have, the company as a data science team that just, they’re just, [00:25:30] there is amazing as all I can say. And they’re magicians, in my eyes and, and they created a technology, a platform call, they call it Nate. And that, platform, especially when it came to COVID was highly tuned so that we could follow our patients, offer, information, insight. We could predict surges. We could predict [00:26:00] bed statuses. We saw all of that activity all the way down to the single bed. And it was just phenomenal about how it enabled us to not only, care for our patients inside of our hospitals, but actually care for them across a marketplace as well. So we could leverage back to scale, leverage all of our assets, just because of the insights that we could get.

[00:26:26] The other area is that we, again, before COVID we [00:26:30] began the creation of a product called rhythm, which is, in simple terms, which is just tiles that, represent all kinds of different metrics in our organization from census to supply chain, to, lab turnaround times. And the tiles are completely configurable by the operator.

[00:26:50] And then each tile can be set up for alerting. So if turnaround times, increased beyond a level of acceptance, An [00:27:00] operator would get a buzz in their pocket and says, Hey, you got to go look at in the ED or look at some, something in supply chain because something’s not going right. And so having that real time kind of tile based system was really, really important.

[00:27:14] And then, the data also enabled us to create some great partnerships with some other companies. So I don’t know if you are familiar with our relationship with Google during COVID, but we help them, create, the [00:27:30] overall national response system, which took data from us and included it with other types of, healthcare systems in order to do even broader, predictability.

[00:27:41] And then we worked with GE on their command center product, which not only gave us great kind of, air, you’re talking about dashboards gave us some great air traffic control type of tiles, but the residue of that benefit was it that said some of our data was being combined [00:28:00] with other health systems so that we could get a better idea from. For instance, the state of Florida to get a better idea of what the surge was doing on a broader scale by combining our data with others. 

[00:28:12] Bill Russell: [00:28:12] You know, that’s, here’s the thing that’s fascinating to me about that, you already mentioned eClinical works, so I’m going to assume you’re not on a single EHR from one end to the other. In fact, you’re probably pretty far from that, that Nirvana, if you will, of one EHR from one end to the other, but [00:28:30] you’ve been able to, because of that data warehouse, you’ve been able to take not only the EHR data, but probably a lot of other data sets and create a really powerful and useful resource in that instead of relying only on the EHR, you’re able to create a more holistic view of what’s going on, not only in your system, but in the communities that you serve.

[00:28:52] Marty Paslick: [00:28:52] You’re you’re absolutely right now. Now we’re are fortunate that in the employed physician space, the majority, [00:29:00] 90 plus percent of our physician practices, muse, ECW. The majority of our hospitals use Meditech, but we have an Epic presence inside of our hospitals. We have a Cerner presence, but to your point, the really sweet part of it all is it’s all in this abstracted database.

[00:29:19] And today we’re including things. I mentioned mobile heartbeat and the communication platform that we have in the company and the really cool thing is [00:29:30] we are now taking data from those text messages and including that in the warehouse as well, to see if we can see correlation between text message volume and outcomes. And so the ability to take data from all the sources that  we’re talking about is it is really powerful. 

[00:29:50] Bill Russell: [00:29:50] So given our time, I’m only really going to have two questions left. I’m trying to figure out which, let me see if I can squeeze these together here. So care [00:30:00] to distance, reducing touch points. We talked about chatbots, which is, which is one of those ways that we reduce the touch points. What are some other ways we, we reduced touch points in the, in the care workflow in order to, protect the caregivers and the patients. 

[00:30:18] Marty Paslick: [00:30:18] Well, I, I just would tell you that, it’s. We were already in lots of different parts of the company, making solid strides to [00:30:30] improve the patient’s digital journey, but it, as you, as you’re alluding to, COVID kind of changes the game and we’ve got to find a way to either, limit or eliminate waiting rooms. We have to, do our best to, remove registration desk. We have to do our best to, Schedule at the convenience of the patient.

[00:30:56] And so the full digitization of the [00:31:00] patient’s journey is an obsession with us at ACA now. And in, in, in the middle of the summer, we decided, instead of having one group focusing on digitizing the financial journey versus a clinical journey versus the inpatient versus outpatient, then we just bring the whole organization together.

[00:31:20] So the first time in my history here at the company, We have a team of, of more than a hundred technologists that are focused on a [00:31:30] capability versus an kind of an organizational alignment. So we have a team called the patient digital journey and then their job is digitize. It all. we want to see ourselves digitizing a driver’s license, insurance cards.

[00:31:47] We want to make sure that we use messaging as a workflow. We want to, if you want to come  see us in an urgent care, we want you to your waiting room should be your living room. [00:32:00] And we said, based on traffic or whatever, go, Hey, we are ready to accept you. Once you’re in our parking lot, text us that you’re here and we will bring you into the urgent care that’s where back to convenience and confidence for patients really matter.

[00:32:16] And so I’m super excited. 35 years of the company, you can start to guess my age, I’m a, quite the user of our healthcare system as well. And, so. So I always look at this, [00:32:30] Hey, this is what I want as a patient. This is how I want to engage with the organization. And I’m just so excited that the CEO of the company feels exactly the same way. I would tell you that the digital journey for the patient, is a top two or three technological priority for us at HCA. 

[00:32:52] Bill Russell: [00:32:52] Actually we used to when we said hey, we’re bringing these teams together. We used to like slide them all into Nashville, put them in a room and have [00:33:00] conversations. But from a work, from home standpoint, you probably. Well, they probably all are just meeting virtually. Is that essentially how you guys are doing it? And are they coming in from all over the country or are mostly national? 

[00:33:15] Marty Paslick: [00:33:15] Well, so  first of all, we were, again, you just get, you get lucky a little bit and, and IT was already a telework organization prior to COVID now not like it is today, [00:33:30] obviously. But, we’ve been teleworking since 2003, so we had at least have a taste of it. And so when COVID sent, those type of colleagues home, you’re exactly right. We started to work from all different directions, and all different teams. I mentioned the GE command center. Well using WebEx, teams, we, we had a team room where we had engineers from GE and [00:34:00] engineers from HCA, from all over the country, working step by step and updating each other through that teamwork, a team room activity. 

[00:34:09] Now, one of the funniest moments was someone in one of these team rooms one day says, Hey, I’m going to schedule a meeting next Tuesday. And I was, I was being a little bit of a smart L like. But I, I responded, what’s a meeting and my hope, my whole point was this is the meeting. This workflow that’s going on in this [00:34:30] team room is the meeting. And so if you’ve got something to say it in here and let’s get, let’s get the work done. 

[00:34:37] And so, my biggest worry is actually  burnout. I think, our technologists because of the mission, they just, they’ll do anything, early on, I usually get this report that says, it shows any of our colleagues that have worked more than 60 [00:35:00] hours a week for three weeks in a row, because I want to check in and see what’s going on.

[00:35:04] Why ask in to run the report back in may. And we had a dozen to two dozen employees that it wasn’t 60, it was 80. And so I called, I called them up for a little 15 minute calls and the same response happened time and time again. And that was back to them being healthcare professionals and they, and they say, look, I’ve always felt connected to the patient but I realized this [00:35:30] was my moment. I had to get that lab interface up. I had to get this body of work done and I was going to do whatever I had to do to get it done. And so one of the things that I’m trying to stress with our management team is stay connected to these great technologists and make sure that we’re, we’re getting the work done and we’re doing in a mission motivated way. But then we’re also staying healthy. 

[00:35:56] Bill Russell: [00:35:56] It’s a different work environment when you don’t see them every day and you don’t [00:36:00] talk to them every day that they can get lost. And, it’s great that we’re starting to see the management structures form around this, but you already had experience with it. Here’s, marty, first of all, thanks again for coming on. This has been a great conversation. I want to close with this question. What do you think the lasting impact of COVID is going to be on health it in your organization? 

[00:36:22] Marty Paslick: [00:36:22] Well, I wish I had a dollar for every time I’ve turned to the organization and I’ve said, I’m not going back. I am not [00:36:30] going back to pre COVID. And when I say that, I’m really talking about, we’ve had this phrase, I’m sure every other health system says the same thing and we call it COVID speed. And that is, how do we, what we, what did we learn? How did we become so fast at everything?

[00:36:51] Well, some of it was what we just talked about mission motivated, right? People who saw their moment but that’s not the sustainable part obviously, [00:37:00] but we also discovered the power of WebEx, the power of really using a team room to have activity moving all at one time and really staying in sync with each other. And so I do think, I do think COVID speed is real, and it’s gonna allow us to say, look, you can have a portfolio back to 375 projects. But which 50 of those projects are critical for the company’s success. And are we willing to commit the [00:37:30] resources and the money to optimally move those along? I can say for HCA, that lesson learned is the answer to that question is absolutely.

[00:37:38] Yes. And so we’re seeing ourselves stratify our portfolio so that we can really concentrate on the things that make the biggest difference. And then, and then they can happen. at the end of the day, I don’t, I don’t know what else to say about what we’ve learned, except that I feel like at least [00:38:00] at HCA and I’m sure many other people would say the same thing, that from a technology perspective, if we thought we felt close to the patient before, before COVID, we found a whole new level.

[00:38:13] Whether it’s digital patient journey, whether it’s telehealth, we’ve we found a new connection. And, I mentioned earlier in our conversation today about our mission statement and, I just would sum up [00:38:30] that we, It all comes back to being above all else. And I think, for our organization, our commitment to our clinicians and our patients and the rest of our colleagues has really been amplified by COVID and we’re never giving it back.

[00:38:51] Bill Russell: [00:38:51] Yeah, that’s that’s fantastic. Well, Marty again, thank you for your time. And, just taking the time to share your experience [00:39:00] and  your expertise with the community. It’s really appreciated. 

[00:39:03] Marty Paslick: [00:39:03] Bill. Thank you very much for the invitation. I really enjoyed spending time with you. 

[00:39:08] Bill Russell: [00:39:08] What a great conversation. That’s all for this week. Don’t forget to sign up for clip notes. It’s a great way to support the show. It’s also a great way for you to stay current. If you’re not familiar, clip notes is an email that we send out, immediately following the shows actually 24 hours after the show airs.

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[00:39:51] Okay. This show is a production of This Week in health IT. For more great content, you can check out our website this or the YouTube channel as well. We continue to modify that for you to make it a better [00:40:00] resource for you. Please check back every well. when to check back, we publish three shows a week.

[00:40:05] We have the news day episode on Tuesday. we usually have solution showcase every Wednesday and then an influencer show on Friday. but right now we don’t have any solution showcases. So we are doing multiple, We were dropping multiple, influence episodes. So a lot of content being dropped, between now and the end of the year.

[00:40:25] Hopefully you’ll like that. And also we have the end of the year episodes coming up and I’m looking [00:40:30] forward to those. We have the best of the new stay show. So we take. 10 news stories that we covered this year and, give you some clips, give you an idea of what we went through this year. Obviously COVID was the big story, but a lot of other things happened this year in the world of felt it, we’re also doing a best of the, Of the COVID series itself.

[00:40:50] If you remember, we did three months of daily episodes and we go back and we visit that time. And just some of the wisdom that was dropped by the leaders during that. And then of course we do our end of the [00:41:00] year, top 10 countdown of the top 10, most listened to shows of the year. So you’re going to want to stay tuned for that. That’s we take a break the last two weeks of the year. And during that time we don’t stop dropping content. We just prepare it ahead of time and, make it available to you. So hopefully you’ll enjoy those, this year as well. thanks for listening. That’s all for now.

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