University Hospitals' innovation accelerated during the pandemic; here's what is coming next

David Sylvan, president of UH Ventures, the innovation and commercialization arm of University Hospitals in Cleveland, sees innovation as essential during the pandemic.

Mr. Sylvan outlines the projects he is working on to support the health system's efforts to care for COVID-19 patients and plans to resume elective procedures.

Question: What are your top two to three priorities today?

David Sylvan: As anyone in healthcare delivery can appreciate, we are simultaneously pursuing a number of parallel tracks. Each work stream is driven by our system's unified command center, focusing on an overarching set of imperatives for our patients; our caregivers, and our community.

Inasmuch as Ohio in general, and our system specifically, might be experiencing a more muted impact compared to other states and regions, we certainly haven't been unscathed by the pandemic, and continued preparation and positioning for any uptick in infection rates and admissions remains an ever-present priority. This includes continuous monitoring of PPE burn rates for each category with our supply chain leadership; physician and nurse load balancing by location; expansion of infection and antibody testing, etc.

Simultaneous to these measures, UH is also well into our reactivation and readiness planning. This multi-faceted initiative focuses on developing relevant and actionable communications for our system and community; tailoring health advice and solutions for various organizations and businesses, and directing employees and employers to the appropriate resources. These playbooks will be aided by technology, and a variety of novel solutions are currently being vetted.

We're also building and pressure-testing the sequence and timing of the re-opening of certain of our facilities for non-essential and elective procedures. This is obviously aligned with our reactivation planning, and will be informed by an ongoing assessment of our system's conditions; guidance from state and federal authorities, and an understanding of backlogs and the capacities to deploy informed by our data and analytics teams.

Finally, and this is certainly not an exhaustive list, we remain very vigilant when it comes to the emotional and mental wellbeing of our colleagues, especially those on the frontline of care. We have mobilized a number of resources in this regard, and are fortunate to have an existing integrative health platform through which these offerings are continually refined and delivered.

Q: How do you anticipate COVID-19 will change your strategy in the next six to 12 months?

DS: Let me speak to the UH Ventures and Innovation strategy for now, as our broader system's strategy is going to continually be informed and adjusted in response to multiple variables that are still to play out. If this crisis has revealed anything, it’s that rapid innovation is essential, and not just in the areas of therapies or devices, but the manner in which we partner with nontraditional or previously unaffiliated businesses and eco-system partners. Here at UH, we have benefitted greatly from the willingness and enthusiasm of local, regional or even international companies; designers and engineers, and their generous offers of their time; their skills and knowhow, as well as financial resources to assist us in this fight. Moreover, the beneficial outputs of these collaborations are happening at unprecedented speeds.

So, one of the primary strategic pivots for our platform will be a deepening and extending of these collaborations well beyond crisis response. To be candid, there are many industries who have already solved for some of the same challenges we face in healthcare, or at least their parallel instance of the same problems. We've also proven repeatedly over the last two months, that we can get a product or technology into proof-of-concept or pilot activation in a matter of days. The same for clinical trials. These endeavors traditionally took many months to go live but through collaboration and a collective urgency goal, previous hurdles are now being fast-tracked into controlled deployment without circumventing any of the necessary stage-gates.

I'm not implying that this break-neck speed is sustainable nor reasonable, but we do intend to work with our colleagues in various domains to ensure that we never revert back to a pre-COVID pace of operationalizing opportunities.

There are numerous additional strategic adjustments that we're contemplating or designing for, but I'll just add that it's critical for provider platforms to lean into digital enablement when it comes to the delivery of care, with substantial reliance on a robust data and analytics platform to guide; deploy and measure outcomes and impact.

Q: Where do you see the biggest need for technology resources and budget to support caregivers through this time?

DS: As I alluded to earlier, it's unlikely that we will merely revert to the same volume of traditional face-to-face encounters we're all accustomed to as patients and providers. Systems have to more aggressively embrace the remote delivery of care, and so monies and time-resources will have to be funneled towards things like telehealth initiatives; decision guidance platforms incorporating artificial intelligence; robotic process automation, and other centralized command and control platforms to inform day-to-day clinical and administrative operations and decision making.

Q: What keeps you up at night?

DS: Many things keep me awake, but I'll mention two:

Regionalism. No matter how well our hospital system prepares and reacts to this crisis, and how effectively we impact the severity of the pandemic for our patients and caregivers, we are still susceptible to the decisions and actions of our neighbors; the next county; the next state, etc.

Our inability to align nationally on the very fundamentals of surveillance; screening and testing, implies that we're likely to see a resurgence of cases once the rules of social distancing are relaxed and creatively interpreted by other jurisdictions.

Second, we have still not solved for numerous supply chain challenges. Will we be able adequately stockpile enough critical PPE, or secure dedicated sources for the various equipment needs that left us so vulnerable at the outset of this crisis?

Q: How do you see COVID-19 changing the health IT landscape going forward?

DS: I believe that there is a need to accelerate the virtualization of some of the patient-provider encounters that we've all become accustomed to. As we've discussed above, telehealth and remote monitoring; AI supplemented diagnostics; technology enabled healthy at home, for example, and all of the variants that you can conjure, these are here to stay. Reimbursement rules will have to be vigorously re-considered in order to allow healthcare systems to remain financially viable in this new normal, and the sustainability of legacy modes of care delivery should be scrutinized. This will change the access paradigm, and hopefully for the better.

Privacy and security vulnerabilities will need to be front and center, as will the need to adjust the delivery modalities by each patient cohort or population. Provider systems will need to continue to de-emphasize their bricks and mortar strategies, and this will further challenge and possibly burden those IT infrastructures that are under-resourced.



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