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 Welcome to this Week in Health It where we amplify great thinking to Propel Healthcare Forward. My name is Bill Russell Healthcare, CIO, coach and creator of this week in Health. It a set of podcast videos and collaboration events dedicated to developing the next generation of health leaders. We have a live episode this week, Friday from 11 to 12 Eastern Time.

We're going to talk about funding Telehealth's Future with a great panel. And your questions. Maurice Vickis chime Public policy is going to really spearhead the conversation. We have, uh, Pravin Chopra, CIO for George Washington University, Dr. Stephanie Lar, C-I-O-C-M-I-O for Monument Health, and, uh, Al Albert Orel, the CIO for Rady Children's in San Diego as rounding out the panel.

I'm really looking forward to this. I think it's gonna be a phenomenal conversation. If you are wondering what the future of telehealth funding's going to be, you're gonna wanna . Tune into this and, uh, interact with our panel. Uh, mark it on your calendar. Invite a friend. Let's make it a party. This Friday, 11 to 12, this episode and every episode since we started the C Ovid 19 series has been sponsored by Sirius Healthcare.

They reached out to me to see how we might partner during this time, and that's how we've been able to support producing daily shows. Special thanks to Sirius for supporting the show's efforts during the crisis now onto today's show. This morning we're joined by Charlie Larsson, the, uh, RN Senior Director at Banner Health in Phoenix, Arizona, uh, where he oversees banner's, access center operations.

In addition, he is currently serving in a temporary role as RN program director for the Arizona Department of Health Services, COVID 19 Emergency Response Team. And Angie Franks the president and CEO of Central Logic. Uh, an industry innovator in enterprise visibility and tools to accelerate access to care.

Wow, those are big introductions. Good. Welcome to. Great. Thanks for having that. Thank you. Yeah, I'm looking forward to the conversation. You guys have been busy and I think it's for good reason. I think it's a really interesting, uh, solution. So Arizona surge line is what we're gonna be talking about, and it provides transparency across the state of Arizona for constrained resources during the, uh, pandemic.

Um, I'm just gonna throw the questions at you guys determine who, who's best able to answer it. But I, I'm just gonna start with the beginning. So what's the genesis of the solution?

Well, I, I'll go ahead and start. Um, and then Charlie, go ahead. If you wanna jump in. Uh, the genesis overall for Central logic of our solution, we have been in business for over 10 years working with health systems on, uh. Uh, helping orchestrate, uh, care, getting patients to the right, uh, location for the care that they need in the most timely and efficient manner possible.

And typically this is, these have been patients in high acute, um, with high acute conditions. So, uh, that is all about making sure that, uh, that they get that care and, and generate much, uh, better clinical outcomes. Banner Health has been a client of ours for a number of years. Uh, going on two years now and, uh, I have been doing some really innovative work with Central Logic and I, I would say that was the genesis of how we got started with this project in the state of Arizona.

And Charlie is certainly the, uh, the right person to describe what that, uh, what that's all about. So, Charlie, I'll let you, uh, give an overview. Oh, sure. Thank you. Um, yeah, so as Angie mentioned, banner Health had been, um, has been the client of Central Logic now for going on two years and, and have had a lot of, lot of success with it.

And, um, you know, as this, as this Covid pandemic has, has started to spread or, uh, has been spreading, um, the department.

What do they wish they had done differently? What's gone well? Uh, because in Arizona we've been a little bit, um, lagging, not, not lagging, but, um, we weren't experiencing the surge at the same time as some of these other places were. So we were much more in preparation mode. So one of the things that we heard was, you know, you never know where these, these pockets of covid 19

hospitals in.

Um, and so what they told us was, you know, we'd have some hospitals who are, you know, bursting at the seams and need, uh, ventilators, need capacity, need nurses, and we have other hospitals with capacity and everything kind of waiting for patients. And so what they had wished that they had done is exactly what, what we enacted was, um, something to load, balance these patients as they're being transferred around the state.

Um, we.

Uh, so that no one hospital gets overwhelmed while again, another one has the resources available so that they can get the quick access to care. So in partnering with Central Logic, uh, we've been able to, um, do that successfully, uh, with all the visibility and the integrations and, and, um, and protocols and procedures to make that successful very quickly.

Wow. All right. So. I'm gonna go, I'm gonna go straight to the questions. I think ACIO for a health system would ask, obviously banner, I think it's the largest in Arizona, but you have, uh, you have dignity, which is now common. You have, um, uh, gosh, you have so many great health systems down there, but you have a lot.

Honor and some others. So you're gonna have integrate all those in order for them. Communicate at what does that look.

Yeah, that's right. So there, there are quite a few, um, kind of what, what we would, they use bunny ears care, uh, major health systems in the, in the Phoenix Metro in Tucson metro areas. And, um, what we found that we needed to be able to see and integrate and, and work together on the most was the bed visibility.

We need to know who has beds when.

Who has the staff and those kinds of things. And so, um, a, a big win for us was that our, and, and what made this successful earlier was that our, our state health information exchange held current, um, already had ADT interfaces with 95% of the state. And so where with Banner Health, we have a specific integration with Central Logic for.

What, what the I allowed us to do.

Uh, to be able to, uh, see the beds across, across the state and, and it, you know, it's, it, it's not really a flip of a switch for everybody at once. So we start with the bigger systems, uh, and then just keep kind of plugging away until we get, um, everybody's bed visibility. So, so is it basically just ADT feeds?

Is, is that what you're picking up from the EHR and from the, uh. That, that's really the basis of it, because the ADT fees, they has the information in there that, um, that has, you know, all of the beds. And so where are the beds located? Uh, what kind of service? It, it an ICU bed, is it? And is there a patient in, so with the a DT fees, then Central and current has.

Partner system transfer center, um, experts.

Um, and.

Yeah, so that's the, so Angie, I mean, the natural next question is if the HIE has a lot of this information, uh, what, what is Central Logic's role at that point, besides being an aggregator for the, the rest of it, I assume there's, there's some reporting, there's some visibility, some dashboards and whatnot that you guys provide out of the box.

Right, right. Yeah. So, um, the HIE made it easier, obviously, to have all of that data pulled together in one spot. But the technology that we've built and designed is really what, um, you know, what I would say is a key part of the secret sauce. It, it allows the health system, or in, in this case, the state and the, the, uh, the call center at the state level to have a master bed board and to have the visibility

To all of those critical care, um, beds and staff, the resources, the physicians, and then the ventilators so that when the calls come in, the decisions that need to get made as to where's the best place for this patient to go. That agent has visibility to who has capacity, who, who doesn't, who's moving into a state where they've got maybe, um, pending demand that is going to put them into a

A status where, um, where we don't wanna route more patients to this facility. We wanna leverage other resources in the state to, uh, to move those patients. And if you look at places like now, you know, in banner's case and in the State of Arizona's case, they had some time to prepare for this. They saw what was happening in other parts of the country.

State or regional level who had capacity and who didn't, and make those decisions in a centralized fashion. That's what we're bringing to the table. So, so we bring the tools and the technology to facilitate that decision making. The HIE provided us a much easier and faster way to get access to that data.

Um, with, without an HIE, we would just pull that ADT data from each individual system. You can do it. It's just a work that's gonna be done at each, uh, IT department. Uh, you know, there, there's gonna be a significant amount of work done in public health, uh, following this pandemic. Whenever it does run, its.

And, uh, you know, it's, it's this, it's these kinds of solutions. So from a, from a public health standpoint, it really had to be driven by the, the state of Arizona. And I can imagine they have a dashboard at that level, but how does the provider sort of interact with that data? Do they, uh, do they go to the state and say, Hey, where's their capacity?

Or do they have visibility down at the, at the system, even at the hospital of how to direct in case. Yeah. So the way that we've, we've built the, the surge line is, you know, it's, it's the technology of course, and like we've talked about with the bed visibility and then the reporting and everything that comes with that.

Uh, but, but what it also is, is it's a, it's a, it's a center of of agents that take these phone calls. So we have all these tools at our att.

The bed visibility, the ventilator visibility. They pick up the phone number, the phone, and they call the, the toll free phone number. And essentially with that call, they're calling every health system in the state, and so they're calling the surge line. The surge line will then, um, we have a, an algorithm of different things that we look at.

We look at the, the. The critical nature of the patient who has the related bed, um, market share and, and who's got the most beds in the state. We wanna make sure that, you know, if this, if one health system has 10% of the total beds and another health system has 50% of the total beds, we, we don't just wanna divvy up one for one.

We wanna make sure that we're, um, we're following that. We look at that, we look at what our last, um, few transfers, you know, where have they gone so that we don't inadvertently send, you know, five or six patients to one system, uh, back to back so that they have the time to bed and, and kind of catch their breath a little bit before we come again.

So they look at all these things. Um, and, and this transfer center, the surge line kind of sits on top of the other surge line, uh, the other transfer. So, imp.

We decide which health system is gonna, we hand the case off to that transfer center, and then they connect the physicians and, and follow their normal processes to get the patient placed. Does that make sense? Yeah, that makes sense. I, you know, I, I'm, I'm sitting here thinking, okay, if I, if I were in charge of this in New York City or Pennsylvania or wherever, and, uh, we brought a task force together and they said, you, you know.

Well, we have HIEs across the state. We'll just pull that information in and make it look nice. Then I can see people saying, well, you know, most of our health systems are on Epic. So, you know, can't Epic just provide, I mean, I, I would imagine the conversation in Arizona probably went down that path as well.

It's like, we could do this, we could do this, we could do this. Um, but the reason you can't, I, I would because.

Um, everything is not as, uh, integrated into an HIE as we would like. So it does require some sort of, uh, inter intermediary layer to, to aggregate and, and to, uh, function. Is that, is that, am I accurate in, in that assessment of how the conversation went? Yeah, I'll, I'll, um, I'll let Angie talk a little bit about the interoperability of the, of the pro, of the platform.

But you know, what, what it does is this, this platform and why it's, um, why it's necessary is, um, it provides a whole charting documentation platform for our surge line agents. And so they will.

Uh, positive, you know, all those types of things. And, and with that, uh, we pull all sorts of reports, all sorts will understand.

Uh, rates of coronavirus per capita in the United States, right there with New York and, and New Jersey. And so we're getting a lot of patients from Northeastern Arizona, from Navajo Nation. And so that helps us understand how many patients are coming from that area. Um, um, at any given time, what are the trends?

And we can look back since the surge line up and all those.

What health.

Yeah. Yeah. And I'll just, I'll just chime in. Bill, you are spot on that, uh, um, the interoperability is the key here, and it, it doesn't even matter if you're on the same EMR many times across, even within a health system, but. Certainly across a state, even if you're running the same EMR, the same, you know, you're both, you're all running epic, you're on different versions of Epic.

You have different configurations of Epic. And it does not, that those systems do not interoperate, um, interoperate Well, this, our technology is truly Switzerland. We integrate not only with the EMRs and the ADT systems, but we integrate and interoperate with many other . Systems to facilitate the decision making process and navigation process of getting patients to the right care.

So I think, I think you also have to look at something that is very purpose built for taking in information rapidly, gathering the right clinical data. Following protocols, timestamping and documenting, and then facilitating the decision, and then getting the transportation, ordering the logistics, and getting the patient to where they need to be.

And it's just vastly different from what an EMR was designed to do. All right, so this is what Arizona's doing a any word on what other states are doing at this point.

I'm throwing you a curve ball. I, I don't, I don't really know. I haven't, I haven't heard of anything like this yet. Yeah.

Yeah. So what I, what I've heard and what I've seen is states right now, there, there, I think there's a call, a conference call with governors and state tasks for task forces that are happening on a weekly or a biweekly basis. Um, they're all, uh, they're all looking at or attempting to do, you know, or thinking about, you know, how they're going to put in place the infrastructure to hap to handle, surge and demand, um, in the future.

I haven't seen anything to the extent of what the state of Arizona has done. We have heard that the state of Nebraska tapped one of the CHI, um, systems, and it's a, it's another central logic client where they are facilitating a similar type of a, um, surge demand, kind of a centralized function, but it is being routed.

Through, um, that health system for decision making is, is my understanding. But, um, but I have not, we have not seen any other states go quite to the level and, um, the, the vision that Arizona has, uh, has implemented against. You know, it's interesting. I mean, we, we need data to make decisions and I see all, all across the board, you guys are talking on a state level, but even on a national level.

Um, and I see even the military is moving those ships around, you know, they're moving into New York Harbor. Then they moved them into, you know, on the West coast where, I mean, there's so many people that could use.

The surge numbers that people anticipated early on, so those ships were not used and the field hospitals weren't. But to have that, even on a national level, you realize there's so many pieces being moved around based on data that's being cobbled together or is not complete. This would be a, an interesting, one of the first public health programs that should be put in place almost nationally so that we can make decisions in.

It, it, I think it is absolutely essential that there is a technical infrastructure to support this type of logistics and this, you know, patient navigation and logistics in the case of any surge, and, and that could be. A mass shooting. It could be a hurricane, it could be an earthquake. The next pandemic a bad flu outbreak.

It, it really, it is really, in my opinion, fundamental to, um, good public health, that we have the ability to integrate, communicate, orchestrate, care, and turn that on on a dime, uh, when, uh, when the conditions demand it. Absolutely. Well, I wanna thank you guys for the, the work you're doing in Arizona. I love your, your governor.

I love following your governor. I, I follow him on LinkedIn and see some of the posts, some great, uh, work being done down, down there in Arizona. And the work you guys are doing is, is excellent. I'm glad we're able to share that with the community, with our community and get that word out there. So. Thanks for having us on.

Bill. Good to talk with you today. Yeah, thanks for the time. Appreciate it. That's all for this week. Special thanks to our sponsors, VMware Starbridge Advisors, Galen Healthcare Health lyrics, Sirius Healthcare and Pro Talent Advisors for choosing to invest in developing the next generation of health leaders.

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