'The best tech is the simplest tech to use': NewYork-Presbyterian CIO on pandemic leadership and the next IT investments

When New York City emerged as one of the early hot spots for COVID-19 cases in the United States the staff at NewYork-Presbyterian, like many health systems, made swift changes that enabled new technology capabilities to coordinate the influx of patients and community inquiries.

"During the pandemic we created an incident command structure," said Daniel Barchi, group senior vice president and CIO of NewYork-Presbyterian. "Section leaders focused on clinical, operational, logistic and supply needs helped us address issues that we might not have otherwise identified in our normal operational structure."

As COVID-19 cases surged in New York City, NewYork-Presbyterian pivoted to maximize capacity and turned operating rooms and post-anesthesia care units into intensive care units to double ICU capacity. Physicians and nurses from all backgrounds and specialties transitioned to focus on treating COVID-19 patients. Mr. Barchi and his data analytics team used data from Italy, China and other sources to predict what the health system would need at the peak of its patient surge to prepare accordingly.

"NewYork-Presbyterian is a data-driven organization, and we've got great resources with Columbia and Weill Cornell, which helped us to evaluate our current capacity, make preparations, and care for patients throughout the surge without compromising quality."

Early on in the surge, the health system's data analytics efforts focused on examining volume trends and responding to clinical needs.

"Our early detection system allowed us to identify Queens as a hot spot and prepare for early volumes at our Queens hospital," Mr. Barchi said. "Then we saw it move to Northern Manhattan and Southern Bronx, and we were able to respond in kind. Early on, we were focused on patients and the number of new positive cases that we would expect to see. We then started digging more deeply into the data and were able to examine the social determinants of health to see commonalities in patients. This allows us to know where to expect another outbreak, as well as the background of the patients we were seeing so we could respond with the right clinical course of care."

The city has come a long way since then; on July 12, the city reported its first day of no new confirmed COVID-19 deaths since March. The city hit its peak of confirmed deaths in one day on April 7, at 597 cases, and as of July 12 New York had a total of 18,670 confirmed deaths, according to a report in The Hill. The city has begun some reopening measures, and NewYork-Presbyterian has returned to focus on providing care for the community at large.

But the need to leverage technology for care delivery with a focus on the social determinants of health will continue. Mr. Barchi said the health system is committed to integrating all of its systems and technologies so physicians and nurses can integrate their workflows and the entire system can realize more operational efficiencies. For example, new technology investments will tie together the infection control system with patient transportation and emergency department systems so all information is in one integrated platform.

Mr. Barchi also anticipates robotic process automation will be an ongoing tool the health system uses to become more efficient in care delivery as well as back office functions. NewYork-Presbyterian has already backed up that vision by more widely leveraging artificial intelligence in the phone system to increase the quality and speed with which it is able to respond to patients.

"During the surge, we stood up additional call centers to be able to schedule COVID-19 testing for patients and answer patient questions," he said. "With the additional volume, we wanted to be able to handle calls efficiently. Now, more than 50 percent of our inbound calls are handled by AI, which listens to the patients' needs and then directs them to the right department. Our ability to ramp up these technology tools quickly points to the need to make these kinds of investments routinely."

Looking further into the future, Mr. Barchi said he is excited by technology that can make a big impact with a low threshold for use.

"It's said that the best tech is the simplest tech to use," he said. "These are the things that can be readily used by nurses and doctors in their practices. It is the appropriate algorithms that inform them with the data they need to make decisions in the moment."


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