How Children's Hospital LA prepared to navigate remote work amid COVID-19

Previous infrastructure overhauls across its network, innovative software and remote access systems have helped pave the way for Children's Hospital Los Angeles' COVID-19 tech response. 

Within one week of California's shut down order in March, the hospital shifted 30 percent of its staff to remote operations, which included about 85 percent of its information services division. This rapid shift to remote work would not have been as seamless without the infrastructure, network and software upgrades that CHLA's Andrew Morris, chief enterprise architect, Steve Garske, PhD, senior vice president and CIO, and the entire CHLA IS team, have rolled out over the past three years. 

"Our Information Services team has been ready for this for a long time," Mr. Morris told Becker's Hospital Review. "Prior to the pandemic, to facilitate our team to be able to seamlessly support our customers, we already built and were using a foundation of digital platforms to enable work after hours and off site."

While CHLA's IT staff may have been more familiar with the working-from-home experience, the health system's other departments including marketing and communications and administration quickly adapted to remote work using tools such as WebEx and Zoom meetings. To further assist employees, Mr. Morris and his team are contributing what he refers to as a "remote worker playbook," which provides educational materials on both managerial and individual levels to help navigate tasks such as using WebEx and running effective virtual meetings.

Throughout the pandemic, communication has remained a constant, critical component to fostering successful remote work operations, according to Dr. Garske. To do this, CHLA has enhanced its meeting protocols and frequency to ensure it maintains the same level of communications that occur in person on the hospital campus.

"From a senior leadership level, we have made it a point to increase the amount of communications with the leadership team and staff," Dr. Garske said. "We've substantially increased the number of virtual meetings with leadership in order to inform everyone on a weekly basis, and sometimes twice a week, about organization updates to ensure they are kept up to speed and can communicate information to their teams."

Dr. Garske and Mr. Morris said they agree that moving forward, one of the biggest challenges they will have to tackle is continuing to maintain information system upgrades and new tech capabilities not only for remote work operations but also telehealth visits.

The hospital aims to increase the number of IoT devices integrated with its Cerner EHR to expand telehealth capabilities and equip its clinicians with as many tools as possible to streamline workflows and patient experience. Ramping up its telehealth program during the pandemic has been a key focus for CHLA's IS team and clinicians. Prior to COVID-19, the hospital's telehealth visit average was about 100 per month, but since the pandemic started, CHLA is now approaching 50,000 telehealth visits.

Another constant and growing component of CHLA's IT strategy has been cybersecurity, according to Dr. Garske. As cyber threats related to the COVID-19 pandemic continue to increase across the globe and span several industries, hospitals and health systems have seen spikes in email phishing campaigns and malware attacks from hackers impersonating organizations such as the CDC and World Health Organization.

Dr. Garske said that while CHLA has seen an increase in phishing attempts across the organization, the hospital fortunately has been able to avoid any major events. He credited this, in part, to CHLA's preparedness and employee training to identify email phishing attempts. Led by Conrad Band, the hospital's CISO, and the IS security team, CHLA continuously conducts practice internal phishing email exercises to train staff how to properly identify and stop phishing attempts.

"Hackers have substantially increased their phishing attempts, and we believe this will be a template for future crisis," Dr. Garske said. "Threat actors have become significantly more sophisticated, using pandemic-related messages while attempting to gain access. We have been training our staff through our advanced MyID security initiative as the phishing attempts have become much more targeted."

The increased training coupled with upgrades to cybersecurity infrastructure and capabilities are part of CHLA's ongoing strategy to mitigate security threats and issues, which have improved the organization's pandemic preparedness, according to Mr. Morris.

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