From mid-March through the end of May, Atlanta-based Piedmont Healthcare operated in a 90-day crisis management mode, which required all team members to focus on their COVID-19 response.
For the IT team, that meant supporting a steep influx in virtual visits and transitioning a significant majority of the team to remote work. Piedmont went from a few hundred virtual visits per month to ten thousand visits and had to make sure their infrastructure supported that.
"As we started to get a handle on how to manage operations virtually, focus shifted to rationalize certain strategic initiatives as services and elective procedures were brought back online," said Piedmont Healthcare CIO Geoff Brown. "We also wanted to be laser focused on recovery efforts, such as supporting fiscal management and operational productivity. We have continued support of growth initiatives that were in stream but paused when the pandemic began."
For example, Piedmont had planned initially to open a new Tower in Atlanta early August, but as COVID-19 cases surged in the city, the health system decided to open some of the floors up sooner. Mr. Brown and his team were responsible for rapidly bringing the hospital IT systems online and accelerating planned initiatives there.
Cybersecurity-related reconnaissance was another major focus to ensure the operations team could still collaborate virtually in secure ways.
"A number of System Office teams went remote when the pandemic hit; this included a good portion of staff that were non-patient care facing who moved to remote work overnight and we had to stand up that process," he said. "With the new distributed working environment, we want to make sure things flow easier and there is a secure way for us to expand and grow. Behind the scenes we have to protect the system against bad actors that are trying to gain access to our data and systems. In the first version of the systems we stood up, it was all about keeping staff productive and operational. In version two, we are figuring out how to build a business case around new initiatives, build productivity measures and effective remote management."
Throughout the organization, system employees including the health information management, revenue cycle, legal, administrative among other teams are all remote. The teams using new tools and technology are learning how to expertly interface with hospital operational staff supporting upgrades among other required work activity remotely.
"We want to be proficient at doing so by the second half of the year," he said, although he also acknowledged the process is different when most team members are remote. Recently, Piedmont partnered with another group that will leverage the health system's EHR system. Typically, those collaborations begin with a large in-person meeting so both team leaders as well as other staff on the project can connect, learn about each other's' organizations and establish working relationships. That is more a challenge to do rapidly remotely. "We were able to get together virtually and do some of the relationship-building, but we have to be more efficient and operate collaboratively virtually with our vendors and partners. It's all about coordination, process handoffs and execution."
Mr. Brown sees the remote work largely continuing in the future and he wants to make sure that virtual tools will connect his teams and create an atmosphere that allows for seamless collaboration to take the system to the next level. He has implemented more touch points with his team, increasing the number of virtual sessions to coordinate projects and do pre-work.
"From our perspective, the back office process has been a work in progress around making sure each person is comfortable with creating a collaboration team environment that allows them to leverage what they need to succeed," he said. "We want to make sure every staff member can move to a much higher level of efficiency in that environment."
Senior team members who have a background in consulting are use to that type of work, but more junior team members may not be. When the team worked in-person, a junior member that was stumped by a problem could call a meeting in one of the conference rooms with others and have everyone work through the issue together. Some of that can happen electronically, but they have not perfected moving that entire process to virtual communication.
"We continue to refine the response protocols so that we will improve and get better leveraging the tools and technologies we have to work with," he said. "We have found the experience overall surprisingly positive, however more integration is needed to support infrastructure, staff education and so on with our vendor partnerships. The expectation is that we will continue to provide high quality results doing so seamlessly within and outside of Piedmont.
Piedmont's 2020 fiscal year ended in June, and the pandemic has disrupted the health system's typical process to forecast for the coming year. Projects and initiatives in the works prior to the pandemic were put on hold, and some are no longer priorities as the system moves forward with recovery. Telehealth continues to be significant as secure virtual care has expanded.
"I have been impressed with the ability of our medical staff groups to expand virtual care and the patients' ability to respond, " Mr. Brown said. "That was a big concern for us early on. Over the first week or two, we had to stand things up and get people up to speed with web cams or connect with them through phones and computers. The technical architecture required a variation of applications to interface predictably with mobile devices, cell phones and computer systems to support the community so patients could easily connect. That has been a huge success and I don't see the patient community wanting to go back to normal because virtual care is so convenient."
In partnership with the health system's governance group, Mr. Brown set priorities to re-rationalize the next 12 months and then cascade that information throughout the organization so everyone is aligned with those decisions and ready to execute for the next six months. The plan is to then re-assess heading into the 2021 calendar year.
The investments Piedmont still plans to make in the future include:
• Technology to support System Use-ability / Optimize time in chart
• Infrastructure and application automation
• Cybersecurity Maturity
• Leverage Robotic Process Automation, Cloud and other targeted technology
"We want to get ahead with newer technologies that allow us to leverage more secure information exchange," Mr. Brown said. "Blockchain is showing some real promise. We hope to look at it’s application to revenue cycle to strengthen identity management and secure information exchange. We have talked about doing that over the past few years, but there wasn't a practical application. However, since then there have been significant developments that make blockchain an attractive technology."
His team is also focused on supporting the business of healthcare to accelerate policy changes based on new regulations, and aims to invest in technology that will help them make rapid changes in the future.
"When the regulations were relaxed during the surge of COVID-19 patients, we realized certain efficiencies. Now as we move back to normalcy and those regulations are tightened up, we are looking to capture best practices that we realized and drive those practices as our new normal," Mr. Brown said. "We are doing case studies to capture data points that will allow us to see where we can make changes and decisions on a more expedited basis."