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 Welcome to this week in Health IT News, where we look at the news that will impact health it. 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 IT leaders. I'm gonna do a series of interviews with health system execs who will share their plans for Covid 19 preparedness.

I wanna thank Serious Computer Solutions who reached out to me last week and asked if they could sponsor a series of conversations, uh, to help the industry prepare. I appreciate their foresight. And commitment to the industry they serve. Our first conversation is with Dr. Brett Oliver with Baptist Health out of Kentucky.

Uh, good morning Brett, and welcome to the show. Hey, good morning Bill. Thanks for having me. I should say welcome back your second time guest. Um, uh, you know, it really, thanks for taking the time. I know this is a, is is a busy time for everybody and I really appreciate the time. So let's, let's just get right to it.

The first question's pretty general and it is, what is your health system doing? Uh, in, in, in, in the way of preparedness. This could be clinical or how, whatever other things they're doing with the community. Yeah, sure. As far as for the community's sake, you know, we're just trying to be that trusted source of information, which we, you know, we sort of were, but it's taken it up a notch.

We even launched a separate, uh, website page, you know, just for that information, which. Hopefully can be the place where they can, patients can go in our area, our community, and know what's happening from ACDC perspective, but then also how we're handling it and how care changes. As you can well imagine, the care models are changing to try to keep folks out of some of our facilities if it's not appropriate, and that's a big.

Transition for folks. Big mind shift in terms of how we're approaching things, but lots of potential technology things if you wanna dive into that. But I think as far as we're just trying to be that trusted source of information for our community. Uh, one place that they can go and, and get real information.

Maybe not from the Twitter sphere. Yeah. And well, and we are gonna dive into the health it, that's gonna be the next area we go, but . Uh, or is the principle essentially this whole social distancing? I mean, we, we want to have, clearly we're healthcare. We want to have contact with people. We don't want to have, we, we will have contact with people, but we're trying to avoid unnecessary contact in the case of exposing people, uh, on the front lines to, uh, you know, a potential outbreak.

And so there's strategies that a lot of health systems we saw drive through, uh. A lot of drive-throughs, uh, clinics set up, which sort of creates a, a waiting room in and of itself, the car, which is a self-contained unit. Are there other things like that that you guys are doing? Well, I think, yeah, you, you hit on something.

The social distancing is part of it in keeping folks that maybe don't, they're not sick enough, but could be exposed out of our emergency rooms. But it's also kind of protecting that surge of the worried well that if you come in with an acute MI or some other very potentially fixable thing, that you're not sitting out in triage because of all the folks that are clogging the system, whether that's at an urgent care.

In an office. Now you have to balance that with, you know, I know our outpatient office visits are down tremendously from folks worried about being exposed. So it's, it's a, it's a little bit of a catch 22 from a financial perspective. Uh, and hence why we're trying to ramp up virtual visits and thankful that Kentucky is, uh, leading the way in terms of pay parity, uh, with telehealth services.

Now, some of that's being blown out of the water from federal mandates to make sure that, uh, we have access, uh, moving forward. Yeah, it's, it's, uh, it's interesting, you know, and actually we probably won't talk much about this, but this, uh, do you start diverting some of the other business because there is a normal run rate of business of people who are sick and getting surgery and orthopedics and other things.

Does this, does this impact all of that? Absolutely. As a matter of fact, probably as we're speaking now or they've just finished up, um, our senior leadership board was having a meeting with the KMA and the governor's office to see if, you know, CDC came out this weekend talking about delaying elective procedures.

Okay. What, what constitute elective procedures and trying to come up with those definitions that we can all follow. I. Whether it's so, uh, we don't expose patients, whether it's because we're concerned about a surge and not having beds, converting ICUs, I'm sorry, operating rooms into ICUs and things like that.

Um, but yeah, that's definitely a conversation happening as we speak. All right, let's, let's transition to health it, you know, what. What are some of the things that, uh, that you guys are doing with regard to the technology and it best practices? I guess it at this point we're not, um, if you weren't prepared ahead with certain technologies in place, it's, it's gonna be a, a little late unless you can really spin things up rapidly.

But what are some of the things you guys have done? Yeah, we were fortunate in that we were a little bit late to the game with acute video visits. Uh, we're, we're an Epic vendor and through Epic, um, but I'm thankful that we had that up and running internally for the last year or so. So that's obviously a place where we've been ramping up, whether it's the number of providers.

We actually also cover Southern Indiana and you can't, you have to have an Indiana license. So, uh, making sure some of those credentialing pieces are in place. Um, eVisits are a big thing that we've focused on. Um, e-visit, particularly within Epic, are sort of these, um, evidence-based, uh, vetted questionnaires of sorts that then present that to a provider in an asynchronous way.

And so we added the travel screen to all the eVisits that we had. We actually created one. We didn't know if cough, we have one for cough and didn't know if that one would be so self-evidence that you could kind of screen yourself for, for covid 19 there. So we created a distant additional button that was essentially the same survey with a couple of tweaks, um, that would lead to that.

That's just entitled. I think I might have c Ovid 19 and utilizing that. The providers that have seen these, uh, in our system are just, they're overwhelming us with great ideas, um, in terms of chronic care, follow-up and things that could be done outside of the office now that we can be, uh, reimbursed for that.

Um, so that's a piece of it. Some of that stuff we're just doing for free, but. I can see that continuing to ramp up and pushing other projects to the side. You know, that's as an aside Bill. I think that's something that we're realizing that this is, uh, sort of unprecedented territory and we have another hospital and, uh, surrounding sites that we've acquired and we're trying to go live with them in December on all systems.

It, and it's pretty clear that a lot of this is gonna potentially bump that way off. Well, yeah. And that's, so a couple areas I want to go down with you. The EHR. So have, have you created, clearly you're, you're creating some screens, you're creating some special workflows and whatnot for this is, is there a lot, is there like a, a dashboard now or are, have you, is your team pretty much fully engaged in this and, and what kind of screens and things are they, are they creating.

Yeah, that's great. Um, we placed an, we're still, we're still not all to storyboard within Epic for those epic, uh, folks that are out there. So we still have the traditional banner across the top. So we're identifying those covid, uh, positive as well as the test is pending for the COVID patients. So just an additional awareness to staff caring for, for those folks.

Um, it's interesting that analytics sort of dashboard piece, I think. Last week or two, we've been so scrambling for supplies. The supply chain piece and what are we gonna do with staffing has sort of dominated our conversations that some of the analytics got. Uh, pushed off to the side. Um, and really this weekend, I, I was asking our team to create an executive dashboard where we could be monitoring some things we already do in terms of bed occupancy, but I'm not sure if we have it broken down into ventilator percentage use.

Um, providers that are ill staffed, that are ill, not necessarily with Covid, but that are being quarantined. So try to put that in one place because if we get this surge that some of the areas have seen. Throughout the world. Um, we're not gonna have time to build that. And I think some of that data will be helpful in managing that operationally.

So talk to me about, uh, communication, communication with the community. You talked a little bit about this earlier that you set up a, a page. I know some systems have done chat bots and other things to help people self-diagnose. What kind of things are you guys doing? Yeah. Besides the webpage, we, we've changed all of our on hold messaging.

Um, some of the pa, the patient reminders that go out automatically. Uh, we've got different messaging there. We are investigating some chatbots. There's some great companies out there that are providing these things now, essentially with little to no integration, just point to their site to help, uh, triage things.

We have not implemented any of that, but that's definitely on the radar. I. Um, back to one technology piece that I, that I think is kind of unique and maybe expanding real quick, bill, if I could. Um, remote patient monitoring. We have, uh, some pilots going on to try to reduce readmissions for CHF and COPD, but I can see us easily using that for a moderately ill person, maybe with some comorbidities that typically you might bring into the hospital to be able to send them home with the device and using our care managers to, to monitor it as well.

So, so talk to me about this. We're, we're, we're, we're essentially asking people to self quarantine and whatnot. Are we able to monitor those people who are, have self quarantined or what, or have you thought through that? Or is that something you guys are talking about? So we created a document that outlines, um, some of the CDC recommendations and then we've added to it in terms of what to be looking for if you're self quarantining that, you know, things aren't going well.

Um, but yeah, that's where, that's where we're looking at this remote patient monitoring device. To say, Hey, you know what? This is not the way we had originally intended on using these devices, but what if we could send people home, almost a, a mini home hospital? And I know folks in across the country have been doing similar things, but to allow a care manager, these, this particular product allows us to see six or seven different data points as well as, uh, video chat with the patient if, if, uh, need there without having any kind of integration.

And, and, uh, second to last question, I know I'm gonna go over already, um, and I appreciate your time, but it, it's around people. So we've been told about remote work and those kind of things, and a lot of it staff can work remotely. But I think what, what I'm hearing from CIOs from conversations last week is they had to actually look at it and go, Hey, not everybody can work from home.

They, you know, and, and so, uh, have you guys done that planning of who can work for remotely and, and, and being able to set them up and what kind of technologies come into play as to determining whether they can or can't? Yeah, that's definitely where our infrastructure team, we have leaned heavily on them because to your point, while everyone could work at home, not everyone can work at home, uh, from an infrastructure on the network standpoint, you know, and then there's the typical HR pieces where, you know, it's up still up to the manager over the, that staff, whether or not they have the.

Capabilities of working from home. Although this is a unique territory, um, I know we've ordered a bunch of Meraki devices, uh, and trying to do a lot of things to offload the network as much as possible. We've not gotten to the point that I'm aware of where we're, we're rotating people through shifts or things like that to take it off the network.

But early on through four weeks ago, the conversation was we can't have all of our system services corporate folks, IT department working from home and still, you know, maintain the network. Um, I'll be honest, I have not been privy to some of those, uh, more technical, uh, pieces on the infrastructure team, but I know that's, I just got an email late this morning, uh, about that as well.

You guys have a good separation of duties there and I've sort of eked over into somebody else's area. Are you fine ? Um, you know what, just closing question, which is, what's one thing you would say to a health system that that may be at the early stages of preparation for this? I think really it's outside of technology and it's probably age old, but make sure your communication pathways are clear.

Um, that you're not having to communicate 10 times because 10 times is better than none. Um, it may be too late to, to outline those, but knowing that my team's working on this dashboard and we don't have somebody over in decision support working on the same thing, uh, 'cause we need everybody's hands on deck.

Yeah. And I appreciate that. Uh, Brett, thanks. Thanks for taking the time. I really appreciate you, uh, coming on the show. With absolutely such short notice as well, so, oh, no problem. Bill. I appreciate what you're doing. Uh, thanks. Uh, special thanks for our sponsors, VMware Starbridge Advisors, Galen Healthcare Health lyrics and pro talent advisors for choosing to invest in developing the next generation of health leaders.

Uh, if you wanna check out more of these shows, I'm gonna be dropping a bunch of them this week. Uh, hit the website. They're, they will be, uh, under a, uh, covid preparedness type banner. So I'll try to talk to as many health systems as I can this week. Uh, if you're a health system that's listening to this right now and would like to share with the industry, if you think the industry would benefit from what you guys are doing, I would love to have a conversation with you.

So please reach out, bill at this week in health it.com. Uh, thanks for listening. That's all for now.