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 Thanks for joining us on this week in Health It Influence. My name is Bill Russell, former Healthcare, CIO for 16 hospital system and creator of this week in health. It. A channel dedicated to keeping Health IT staff current and engaged today. Patrick Anderson with City of Hope joins us. He's the CIO there and we talk about a lot of things.

It's been almost a year since he's been on the show. We talk about his playbook, we talk about KPIs, talk about the impact of, uh, covid, OD, the legacy of CO on health, it and other things. Always a great conversation with Patrick. Special thanks to our Influence show sponsors Sirius Healthcare and Health lyrics for choosing to invest in our mission to develop the next generation of health IT leaders.

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You can also go to today in health it.com, and now onto today's show. All right, today we're joined by Patrick Anderson, the CIO, for City of Hope. Patrick, welcome back to the show. Oh, thanks. Good to be here. Bill, haven't, uh, haven't seen you in a year or so, so it's good to see you again. Yeah, it's a, it has been a while we, you came on during the Covid series and I appreciate you doing that 'cause that was a busy time as well.

So I'd say we're half patient care, half research. And, uh, what, what really sets us apart, you know, we're the founding member of the, uh, national cancer, uh. NCI, the National Cancer Institute, and we've been, we've been collaborating and coordinating with cancer centers around the world for, for, for quite a long time.

We've, we've been a, a, a best cancer center in US News and World Report each year for over a decade or so. We've had, uh, just tremendous science bill, tremendous science that leads to these, uh, lifesaving therapies. We're, uh, we're leaders in hematology. Those are blood disorders, as well as solid tumors.

We've created . Precision medicine therapies with immunotherapy, T-cell and stem cell type, uh, science. We really tailor precision medicine directly to the individual patient. We have good manufacturing plants that manufacture the molecules that we put back into the patients to, um, have their own immune system fight, fight off the cancer, and other chronic diseases.

Just tremendous science. So you guys are, you guys are really a, I mean, a research institute, but you're also a destination kind of facility. I mean, I assume you have patients coming from, from all over the country, if not the world. We do. We're they're, they're from all over the world. You know, we, we have a new business called

Access Hope, and it's, it's basically where we're supporting Fortune 100 companies, their employees and their families, and they're all over the world. And then we also, and, and we provide second opinions. We, we work with their prescribing . Oncologists and, and help them make sure they're getting the best care.

And it's a really, a huge growing business for us. The, uh, the access hope for employer groups and employers was, was that part with that. We also have International Medicine Bill where we, we, we take care of patients all around the world. W was that the Access Hope, was that part of the, uh, is that what the Amazon agreement sort of fell into they're doing with employees?

Amazon, you know, is, is one of, one of our customers, and they're a, they're a tough customer. You have to have pretty advanced cybersecurity to be a supplier to Amazon, let me tell you. So it's, it's been great working with Amazon and, you know, they're, they're Fortune one, so basically, uh, a lot of. Fortune 100 companies followed as well.

You know, through through the pandemic, we obviously had to. Stop dozens of IT projects and create new IT projects everything from working from home and optimizing all of that to, to, to screening employees, screening visitors to, to more ICU beds, new workflows, new new builds and, and epic. Just a tremendous amount of work, but really I think what has happened.

So with that, I. Being able to drive that alignment across the enterprise, move, uh, move entities to standards, lower the cost of it and deliver faster, better, and cheaper requires uh, uh, I think ACIO that is focused on that alignment and focused on, on driving those standards. It's been, uh, been quite, quite interesting.

So you're staying busy? Is that what you're telling me? It sounds . Sounds like it. So Patrick spoke moves orange. Give us a background and. Sure Orange, orange County is a, you know, it's a large county south of Los Angeles County, heavy population and a very dense population. It, uh, it, we were just seeing a tremendous amount of patients going from Orange County up to Los Angeles County for, for care.

We really didn't have a presence there. We have 31 . Medical centers all across Southern California, a couple campuses, but people were having to tra travel pretty far across Los Angeles. From Orange County to get that advanced care, to get our life-saving therapies. So we, we decided to invest significantly into Orange County.

We're building a campus in Irvine, but we did open an office in Newport Beach and we're already, uh, at capacity there, bill, by seeing Orange County patients. It's just been, uh, tremendous. So we've hired . A world class leadership team from the best cancer centers across the country to run Orange County. We have Dr.

Ed Kim from Atrium, and he spent many years at MD Anderson. We've hired multiple people from MD Anderson in Houston and our, our president of Orange County, you know, you know Annette Walker and, uh, she came from Providence St. Joseph. Just a tremendous. Tremendous leader with tremendous vision. So Orange County is, is really underway.

Construction is underway for our campus in Irvine. We expect to open doors next year in, in Irvine. You know, it's interesting. I was, I was. So that's, that's fiscal access to care. And when we're, we're talking about virtual access. And telehealth growth in during the, the pandemic. It's interesting. I just, I just saw, and I know you're doing consults and those kind of things, but the, the virtual visit aspect I was reading where oncologists were not, did not feel like telehealth was, was a great.

Experience for them during the pandemic, and it's one of the areas that's really going back to, to physical visits a lot quicker. Is it, is that what you're finding there? Or is it, is it a little different? No, we're, we're embracing virtual care. You know, we were, we had already, um. Contracted with Amwell before the pandemic.

And we were, we were doing the design work and then the pandemic hit. 'cause at, at that point we were doing only about 10 visits a day, pre predominantly international medicine, leveraging other, other platforms. But once the pandemic hit, we did an immediate rush on Amwell. We, we, we stood it up manually with no integration with, with our Epic EMR.

For, for scheduling and so forth. So it was a little, it was a little challenging I think the first couple months. But once we built in that integration for scheduling where the physicians never had to leave Epic, and, and we were really able to leverage the Amwell platform, we went up to hundreds of visits a day, and we're, we're still at that level and we, we expect to, to stay at that level, well into the future Bill.

So we're not, we're not gonna be reducing that. We did see a, a decline in, in ambulatory clinic visits because of the pandemic, and we now see that slowly recovering. Although, you know, the Los Angeles area has just been hit very hard with the pandemic and . So there was a decline in visits, but we're, we're still keeping the pace with virtual care and we're expecting the visits to, to return this summer back, back to normal levels.

Did, did you guys have to care for covid patients or were you more, uh, because you're specialized, not, didn't have a lot of covid patients. We, we, we've been taking care of covid patients since the spring, and we've had to expand our ICUs with the reverse pressure and all of that. We've had to expand that, but, you know, we're, we're experts in, uh, working with patients with compromised immune systems anyways, so it was, it was pretty natural for us to take care of covid patients.

It's just that the patients with the comorbidities and everything is always very challenging. But, but yes, we've, we've had our, we've had our surges of covid patients as well, and it's been, it's been tough. I'll say. It's been tough. Yeah. So.

The impact of, of covid on, on the health system? Well, let's first start from a, from a positive side. The, you know, a lot of people have been talking about how, you know, the pandemic has been hard, but there there's been silver linings, there's been, uh, positive movement at the health system and, and, and it, and digital priorities and different things like that.

What, if any, silver linings have you have you found at at City of Hope? Well, some simple ones is the, the, the rapid, the rapid embracing of, of digital health. And, you know, with the, with the virtual care, with the Amwell platform and then also . Reprioritizing everything to bring more patient experience roadmaps forward, and that that includes more, more education, more online education, as well as getting our, our patient portal more automated around re-scheduling.

As well as, you know, eCheck in, if you get completely checked in, you don't even have to stop at reception and you, you just, you just go right to the waiting room and then, and then you're called. So bringing those things forward. Also, the work from Home Bill, we're probably gonna see 70% of of my IT team.

Staying home permanently. That's, uh, that's probably the forecast. I can't a hundred percent confirm it because we're still working on the, the scenarios and the standards and all of that. But, uh, a big silver lining in determining the productivity of people at home, tweaking their, their environment. Some people are using VPN, some are not for better performance, but.

I'll have to say that the silver lining in that is less office space and actually higher productivity because people are not commuting on the LA freeway system. And you, you know how that is. Yeah. And, and, and, and I'm assuming you're not in the office or you guys have the nicest offices in the history.

Yeah, we are, we are definitely not in the office. My entire team is, is working from home, you know, and that's like over 400 people. So it's, it's been great. That's fantastic. What, what do you think the lasting impact on, on Health it is gonna be as a result of the pandemic? What do you think the, like, the legacy of the Pandemic on Health it is gonna be, you know, I think it's, it's gonna be a continued.

You know, I think, I think now with the pandemic, we've really turned the ship again on providing value. We've been able to, to create rapid applications in Salesforce and, and in other, other platforms. Now the business brings us in, I. Faster and, and earlier for, for, for most strategic initiatives. And they also know that everything has to go through governance anymore as well, especially with tighter budgets because of the pandemic.

So, so with that, I think, I think what we're seeing, bill, is, is a, is a need for it to get in. Early on all strategic initiatives so that we can contribute our value, and that, that's really been, I think, the most inspiring result of the, of the Pandemic for, for City of Hope for it. Yeah. Well, I mean, that's a good segue.

What, what, what will the technology priorities be for, for 21? We're not, we're.

But as, as, as we sort of, you know, progress here and, and, and more and more people get vaccinated, what, what, what will the priorities be around, uh, technology? You know, I think we're really seeing a focus on, on, on patient experience, but one of the tech items is remote patient monitoring. I think we're really gonna expand that.

People want to stay home. People don't want to go out. They do not want to go to the hospital or the clinics. Remote patient monitoring for many, many use cases. You know, we're also building a hotel on our campus and we're sort of building a, like a subacute type capability there so that when patients are discharged, but they need to stay close to their, uh, to their physicians.

Say it's a bone marrow transplant patient or, or other types of . Pretty in invasive work. We'll, we'll have them at our hotel. They'll be doing remote patient monitoring at the hotel, similar to what they would be doing at home and, and then being able to connect . Visiting nurses for doing blood draws and things like that.

You know, I think we're gonna really focus hard on remote patient monitoring and increase those use cases and, and drive that patient experience. And, you know, everything from, from way finding for we're, you know, we, we. We have the Frog app now, and people are actually able to get an assigned parking spot on our campus before they even arrive, which is the closest spot to their destination on campus.

So our, our mobile platforms combined with the patient experience and automation is, is really where we're focused, along with remote patient monitoring use cases. All right, so maybe I've been out of the game a little too long. The Frog app. Is, is what they do to reserve a parking spot? That, that is correct.

It's a mobile platform and they can, they can, they can sign up for their destination and then it will, we have a, a puck on every, every parking spot on our campus now, and we're, we're building a couple parking structures as well, and they will all have the frog puck as well. And we'll assign parking prior to people arriving.

Well that, I mean, that company should do pretty well in Chicago, New York, la, orange County. I mean that parking is, is a serious problem at, at hospitals. That's a that's pretty it, it sure is. Well, this company, I think built their, their capabilities out of airport parking lots. So that's, it's, uh, it's working pretty good for us.

Last week, I keyed you in on something that's unfolding here at this week in Health it. We started off with our influencer podcast a little over three years ago, but since then we've been able to introduce Newsday and Solution showcases, and last year we expanded even further with our Daily C Ovid 19 series, and now we have a daily show today in Health it.

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uh, do you have any, any projects around your major systems that EHR pacs, E-R-P-C-R-M ab? Absolutely. We're working with the, uh, with some of the, the, the, the bigger integrators for, for ERP and, and for future value of enterprise systems. We're really focusing in three enterprise areas. Bill, we're looking at, at ERP, we're also looking at the clinical enterprise and we're looking at the research enterprise and we.

We're working with, you know, some of these top, top integrators. What does the, what does the future look like? What is the value that we can expect and what value can an integrator bring with us to maybe partner with, with getting that value, you know, having some skin in the game on that. So we're. We're doing long-term planning on the business enterprise, the clinical enterprise, and the research enterprise, and we plan to create multi-year roadmaps, multi-year funding to upgrade the, uh, the, the enterprise platforms for all three of those enterprises so that we can optimize value because we're, we're just growing significantly and we need, we need automation everywhere.

We need . We need chat bots. We need artificial intelligence. We need prescriptive analytics. We, we need it all to, uh, sustain our growth. So it's a, it's an exciting time to be in, uh, advanced, advanced cancer. So, so you need, I mean, you need it all, but last year was a, I, I just came back from the jpm. Watched 16 down between, probably between March and and May pre in.

Through the rain of the year. And so are there any projects that just from a fiscal standpoint, that, that have dropped by the wayside that you're like, Hey, you know what, that's, that's, that's a nice to have and we'll, we'll get back to that later. Are, are there any, any of those? There were, there were many of those, especially in the clinical enterprise.

But we're slowing. We're slowing everything down. That's discretionary, sort of how you mentioned it, bill, anything that's discretionary, we're gonna hold and wait. We're reducing our, uh, our spend wherever we can, waiting for the, the return of better, better volumes, better patient volumes to, to drive the, uh, drive the revenue needed for us to pick up the pace again on our, our priorities.

Wow. Man, you, you are probably one of the most succinct interviews I've ever done. I mean, you just, you, you, you hit the, uh, you hit the points. I guess that that speaks to the fact that you are, uh, you know, you, you, your time is in high demand at this point, so you're, you, you're used to answering the questions and moving on, I guess.

Well, you know, I have, I have a great team, bill. We have, we have a great team. We huddle a couple times a week, and we're really focused on interoperating. We have a . We have a playbook and the playbook grows and the the playbook learns. You know, we run the IT department here with a leadership team, and we, we run it through the playbook, the dashboards, and every time we find areas of weakness, we just, we drive KPIs towards that.

We monitor it for a year, and then once it's stabilized and clean, then we drop it and we look for other opportunities to improve. So, uh, so having. Completely aligned leadership team really, really makes the big difference. You know, I, I, I've asked, uh, a lot of CIOs about their, their KPIs and it's, it's really interesting 'cause they're all over the board.

Uh, you would think that at this point in our industry, we would have like a, a standard set of KPIs and clearly look at uptime. But they're really all over the board. And it, a lot of it depends on what type of institution. If you're an academic medical center, if you're a research institution, if you're, you know, if, if you're cancer and, and, and blood disorders and those kind of things, you're gonna have a different potentially set of, of KPIs and others.

And that's, that's one of the things I found really interesting as I was having these conversations. But, but you have a, a pretty solid set of, of KPIs around what you're trying to drive towards. Th That's right. It's really, it's really based on, on supporting the, the CMIO and his clinical informatics as well as the the CFO and, and their needs.

And then research as well. And we have service level agreements, we have KPIs, we have dashboards, we monitor the health of it, service delivery, as well as . We have an amazing PMO and we, we, we really watch the, uh. The performance of our projects very, very carefully. And we have a very comprehensive governance bill.

We have, uh, five governance committees over five areas of the, of the business, and then they all roll up to an enterprise governance that I chair with all of the business leaders that govern those enterprise areas. And, uh, and we, we drive that alignment. So I'm driving alignment, uh, in the business and then I'm driving alignment within it.

And if you can keep all of that heavily coordinated, then, then all you're working on is really the exceptions and you're bringing those exceptions forward into alignment. And that's what the KPIs do. That's pretty cool. What, what's, what's your EHRI? Epic. You're, you're an epic shop. Are you, are you pretty, pretty, uh, you know, it's given what you guys are doing, are you close to foundation or is it highly customized?

No, no. We're, we're, we're close to foundation, but we still have a lot, a lot to do. Our epic implementation is only three years old. You know, when you look at other organizations that have had it 15 or 20 years, they're, they're mu much more effective than us. We're still doing a lot of manual work and, and we have a lot of, a lot of work to do and the pandemic really slowed us down.

But, but we're, we're, we're getting there. No, that's, that's fantastic Patrick, as always, thank you for. I, I love your wisdom. If people want to hear about the playbook, we actually did an episode on the playbook where, where you shared the, uh, components of that. That's, they'll have to dig back into the archives.

That was, uh, wow. What was that, three years ago now? Yeah, that, and I'll tell you that playbook has evolved. . Well wait, we'll, maybe we'll have to next time. Next time you come on. We'll, maybe we'll have to revisit the playbook and, and go through that. Sounds fun. Sounds good, bill. Thank you, sir. Take care. All right.

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