Why technology is a resilience-enabler for today's distributed healthcare models

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In the healthcare sector, resilience is a top priority. Even before COVID-19 arrived, health systems had started to invest in technology to support emergency preparedness, as well as to respond to the needs of the populations they serve. The pandemic, however, has offered new insights about the importance and difficulties of achieving healthcare resilience.

Becker’s Hospital Review recently spoke with Eric Chetwynd, general manager of healthcare solutions at Everbridge, about the future of health system resilience in the post-COVID-19 era.

Open hospital campuses are a thing of the past

In early 2020, most hospitals rapidly restricted access to their campuses and installed screening checkpoints. Although COVID-19-related restrictions are now being lifted, healthcare security leaders nationwide are reconsidering the traditional open-campus model. Many organizations intend to continue using access policies instituted during the pandemic.

A more resilient hospital means understanding who is on campus. It’s not just about keeping people out; it’s also about knowing who is on site and how to provide a better shield of protection and emergency preparedness around those people. With a completely open campus, it’s hard to manage evacuations and other safety measures during an emergency.

In addition to external events, workplace violence is an unfortunate reality that healthcare leaders can’t ignore. The National Crime Victimization Survey suggests that healthcare workers have a 20 percent higher chance of being the victim of workplace violence than other workers. In April of this year, the United States House of Representatives passed the Workplace Violence Prevention for Health Care and Social Service Workers Act, which focuses on mandating workplace violence standards, as well as programs to prevent workplace violence from occurring.

The patient experience and employee security now extend beyond the hospital’s walls

The impact of COVID-19 goes beyond open hospital campuses. It has also redefined the patient experience. Touchless healthcare experiences are now a reality. Patients and hospital visitors can minimize their interaction with facilities, while still receiving the care and information they need. Helpful technologies include visitor management systems that enable rapid management of people entering the campus, as well as digital wayfinding solutions and systems that manage where people are going.

“Hospitals are looking at technologies to limit access, while simultaneously providing a positive patient or visitor experience for those who are on site,” Mr. Chetwynd said. “I think there will be a continued interest and investment in solutions that support these goals. [The Federal Emergency Management Agency], for example, has doubled the amount of grant funding for nonprofit organizations — including hospitals — for programs like this.”

When it comes to risk, health systems have traditionally focused on events that happen within the walls of the campus. Although hospitals have visibility into inbound patient traffic from ambulance services, many leaders hadn’t thought about management of outside security events and crises. The pandemic, however, has changed that.

“What we saw coming out of COVID-19 was increased awareness about risk events that occur outside the four walls of the hospital,” Mr. Chetwynd said “Healthcare security leaders are now looking more closely at events happening around them like civil unrest and situations that affect whole regions like the weather. Circumstances outside of healthcare systems can affect whether patients can get to campus for appointments, as well as whether ambulances can arrive at emergency rooms.”

Another important trend coming out of the pandemic is the rise in telehealth and more distributed care. Widespread adoption of telehealth solutions is causing health systems to rethink how they deliver care.

“We’ve heard from multiple systems that before COVID-19, they provided 5 percent to 10 percent of their care remotely or via telehealth,” Mr. Chetwynd said. “Now they expect 20 percent to 50 percent of their encounters to happen that way.” There has also been a significant increase in home health programs. Since CMS issued waivers last year that allow providers to deliver acute care in the home setting, the number of patients discharged from the hospital to home has grown significantly. As a result, more nursing staff is now out in the field providing care to patients in the community.

New distributed care models coincide with the need to provide a safe work environment for employees. In response, health systems are considering how to extend their duty of care and protective envelope for staff. Many security leaders are grappling with what resilience means from a physical protection perspective.

The Internet of Things can expand the reach of healthcare security teams

Historically, health systems have responded in real time to safety-related events using a people-centric approach. As Mr. Chetwynd noted, “If there is a security incident, we send security guards. If there is a health emergency, we send clinicians to respond. I think a real opportunity moving forward is to leverage the Internet of Things. With hyperautomation, we can integrate people, digital systems and physical systems to respond to emergencies.”

A fire in a hospital building is a simple example that illustrates the power of hyper-automation. In this situation, the fire department would respond and the on-site emergency management team would coordinate activities. At the same time, building-wide systems could respond automatically by closing fire doors, reversing the HVAC airflow and turning off oxygen tanks. If the fire is located near a data center, information flows might be rerouted from an IT infrastructure perspective.

IoT systems also offer great opportunities for improving the safety of distributed care. There are a number of IoTenabled solutions that can extend clinical and acute care capabilities into the home setting and then tie information back into remote monitoring systems at the hospital.

“IoT is definitely something that most hospital leaders are looking at,” Mr. Chetwynd said. “Given the diversity and complexity of critical events that happen on a daily basis, healthcare systems need to provide an expedited response, reduce personal interaction and increase the span of teams to provide protective care.” 

Technology is foundational for healthcare resilience, but cybersecurity and infrastructure issues must not be overlooked

As health systems implement IoT systems to promote patient, visitor and employee well-being, teams need to consider cyber risk. According to Mr. Chetwynd, “As organizations think about strengthening their facility infrastructures and their distributed infrastructures, they need to give a lot of thought to cyber risk. This is particularly critical now that home networks are becoming a part of the healthcare IT infrastructure.”

IT infrastructure is also an important consideration when building new healthcare facilities. Organizations must design technology systems that are adaptable and resilient. “Several of our clients are expanding their health systems and building new towers,” Mr. Chetwynd said. “They are thinking about which technologies are the right ones and what those choices mean from an IT and physical infrastructure standpoint.” 

Many tools are now coming to the market that can enable a better patient experience, greater flexibility and improved responsiveness to employee needs. For example, leading healthcare IT teams are exploring new technologies like low-energy Bluetooth, as well as new access points from a Wi-Fi or IP perspective.

Conclusion

In the coming months, most health systems will be taking a broader view of risk to include everyone who is getting and receiving care. “We are starting to see organizations think beyond the traditional space,” Mr. Chetwynd said. “I think that will be key for healthcare organizations as they figure out how to adapt and flex in response to trends like distributed care models and more restricted brick and mortar campuses.”

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