Presbyterian Healthcare Services CIO on IT team's new operating model: We have to deliver more quickly than ever before

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At Presbyterian Healthcare Services, CIO Julie Bonello is leading her IT team to embrace a new operating model that supports the Albuquerque, N.M.-based health system's refined digital optimization and transformation strategy.

As senior vice president and CIO of Presbyterian Healthcare Services, Ms. Bonello oversees all IT assets across Presbyterian's health plan and healthcare delivery system. Since March, she has been spearheading the healthcare organization's efforts to transition to remote work and adapt to new clinical systems to support COVID-19 and alternate care delivery workflows, both in the hospital and for telehealth.

"For everyone in IT, the volume and speed with which we now have to deliver is really enormous," Ms. Bonello told Becker's Hospital Review. "We in IT have had to change the way we work from March of this year forever looking forward, so we're changing our operating model into how we're now delivering services, and it changes everything we do."

Nearly everyone on Presbyterian's IT team, about 350 members, is working remotely due to the pandemic. There are about 20 IT employees on the client services team onsite managing calls at the health system's administrative center and 30 IT employees going out into the field, but the rest of the team is working from home.

The shift from in-person collaboration to remote work has required the IT team to adopt a new way of working together to quickly design systems that support new digital workflows. To keep up with the challenges of the increasing volume of work while promoting sustainability, the team has placed a great focus on resiliency and change management, Ms. Bonello said. While team members are at different stages along change management, it's important for employees to understand that is OK and to support each other to foster resiliency among the group as a whole, she added. 

"We have to work differently now and the volume has increased, so we need to help each other out when we have difficulties," Ms. Bonello said. "Doing that in a remote environment when we've always worked so closely together face to face has been a new way of working for us; we now reach out frequently even if to spend time just talking."

With Presbyterian's shift to digital services across the continuum, the health system has rolled out new services including telehealth, COVID-19 testing in a mobile unit, pre-appointment check-in through the EHR and patient portal and iPads to monitor patient rooms, all to limit the number of touch points and reduce coronavirus exposures while giving patients better access to care when needed.

Transitioning to digital has required "IT to deliver more quickly than it ever has before," Ms. Bonello said, adding that her team has adopted a new organizational structure in terms of project and program management.

"It's really the movement from a project-based approach to more of a program and product-based approach with our business owners," she said. "It requires a closer integration of our IT service leaders with the business, so that they are planning, designing and building together in very fast iterations."

As Presbyterian's IT division looks ahead to optimize its telehealth and digital advances made during the pandemic, improving care delivery for patients and extending more technologies to move the needle even further remain the backbone of the team's priorities. The biggest need of IT investment in healthcare today falls on network infrastructure and wireless capacity, Ms. Bonello said, as the two must support digital transformation over the continuum of care. 

"We're all using internet service providers for remote access within our home and with various levels of service and broadband coverage. Working remotely, we frequently have connectivity issues," she said. "While our workforce is dependent on the services of their internet service provider, our IT department needs to provide assistance for all different levels of connectivity across our remote workforce."

Ms. Bonello also stressed the importance of the enterprise network infrastructure and WiFi  as Presbyterian rolls out more digital capabilities both within its provider areas, hospitals, clinics and procedure areas but also as the health system plans to move digital capabilities and telehealth into home care. Building upon these services, interoperability has also become an important investment as health systems increasingly share data and connect disparate different devices such as wearables that capture patient information from across the continuum.

"With patients participating in their care, interoperability will allow providers to integrate health data over time with the tech that patients use in their home," Ms. Bonello said. "… More and more you're going to find that clinical information will be shared to not only allow healthcare providers to better care for patients but to also allow patients to be actively engaged and really govern their care."

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