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 Welcome to this week in Health IT News, where we take a look at the news that will impact health it. This is another field report where we talk to leaders from health systems on the front lines. 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.

As you know, we've been producing a lot of shows over the last three weeks and series. Healthcare has stepped up to sponsor and support this week in Health It, and I want to thank them for, uh, giving this the opportunity to, to capture and share the experience, stories, and wisdom of the industry during this crisis.

If your system would like to participate in the field reports, it's really easy. Just shoot me an email at Bill at this week, health it.com. Now on to today's show. Today's conversation is with Chief Information Officer for NYU Langone Health, uh, Nader mbi. Uh, good afternoon, Nader. Welcome to the show.

Appreciate it. Hello. Appreciate having me on the show. Well, well thanks for taking a few minutes to meet with us today. I know you're, you're really busy. So I, I really, um, I, I, I will have you back on the show 'cause there's so many things we could talk about. You guys are doing so many creative and fun things in the digital space that, uh.

I think would be interesting to talk about and, and we'll, we'll get a chance to do that, but I, I want to do one of our field reports with you. Uh, before we get started though, give give our listeners a little idea of NYU Langone, your, your reach and, and where you guys are, uh, what, what communities you're serving.

Uh, so we are, um, you know, an academic health system, um, located in, uh, metropolitan New York. Our, uh, main campus is in Manhattan 34th, um, and first Avenue. And then we have, um, um, a hospital in Brooklyn, a hospital in, in Long Island. And orthopedic hospital. And then of course, our main campus made outta the three main hospitals.

Um, and then we have a very large ambulatory footprint, uh, about 400 location, amatory location. Uh, and these are multi-specialty locations. Um, you know, uh, over 6,000 net physician, uh, employees position and employees. Uh. Uh, metropolitan New York and New Yorkers mainly. And then we have two school of medicine.

Uh, one main one, one we opened last year in Long Island. Some of you may know about us that our school of medicine is, um, uh, tuition free and, um, moving beyond the top five, but school in the country. Um, then we have very large research portfolio, which, uh, scientists do. That's, uh, sort of at our institution.

It's, uh, in, uh, in a nutshell. So I think everybody knows this and I'm tracking the numbers pretty closely. You guys are right in the middle of the surge. Um, you have, uh, the, uh, Navy ships now off the coast. You're standing up, or not you specifically, but in New York, we're seeing these reports, um, you know, turning.

It can be maybe changed in negative pressure. So, um, but we continue to expand our, uh, IC sub, um. You know, seeing a number of patients triaging across our hospital. And then we got our, um, students and residents and all the health work at work, um, to serve the community and our physicians from a multidisciplinary, um, all engaged, uh, um, to serve the community.

So, so give us that. Let's, let's, let's, we'll delve into health IT for a second here. So actually for the rest of the show actually. So what's one thing you discovered in the past few weeks that might Ben benefit others that are maybe a couple weeks behind where you guys are at? Well, so first of all, I may talk about, um, crisis and emergency.

So I know people ask me, well, what did you do? It's, we've been, um, fortunately, unfortunately, I've been through many crisis, including, um, September 11 blackouts, Sandy. Storm and of course this. And part of that is our institution having a good emergency planning, um, since even, uh, standing even before that in place.

And that's a broader institutional plan about the know case of an emergency of what to do. And we plug into that and then when it, we create a structure, uh, for many years in place. But how do you deal with crisis now? We all know, and based on my experience, there's crisis all different. So you never get the same crisis again when people thought, you know, so the question is how do you set up a structure to deal with crisis assets and be able to, you know, react quickly, improvise as different issue arises?

So this. Crisis totally different than what Sandy was. You know, Sandy was an event in , and then you have to deal with aftermath. This is continuing. So in such, you have to prepare your staff to dealing with this on everyday basis. And so it's, it's, it's a different type of crisis. So you gotta be very nimble and agile as they need changes to be able to deliver the technology services, whether that's expanding ICU, um, telehealth.

And various other things. And the other thing is about really having, um, your technology architecture in the way of integrated environment and capability really matters. This is what it shows is either crack or strength as how you architected your technology infrastructure. Um, and that's, that's puts at the real here, um, both your staff and your, your structure and your.

Technology capabilities. So what are, what are some of the, as a, from a leadership perspective, what are some of the things you're doing for your staff to, to make sure they're focused on the right things and to make sure they don't, uh, potentially overwork themselves or get into a situation where they, uh, you know, put themselves at risk.

Yeah. So, um, uh, uh, two things. One, our leadership at the top is very connected. Um, I'm part of the, um, senior leadership and we meet twice in the morning and in the afternoon to make sure that we are on sync with clinicians, with our staff, what the institution needs are. Um, and so that's very aligned that way.

And then I meet my team. Every day at, um, noontime to write to, with my leadership, to making sure that we are delivering and aligning our resources, um, uh, to deliver the right things and to focus on the right, uh, problems. Um, so it's a very, we have a very seasoned team. As I said, we've been through many crisis, so everyone knows the playbook and all part is about agility and reaction.

So whether that was expanding tele telehealth, which we invested. Before and all of a sudden that really paid the dividend. So having tasks of people working from home and now we can service them and set up a quick triage, a command center so we can really help people to be productive. Um, or, you know, making sure that we partner with our vendors to get the equipment we need or integration points we need, and having them prepared to help us.

So, you know, a lot of these, again, it's requires the structured investment you make. This is where you see the dividend pay off the readiness. And I, I always see people that you always have to be ready for a crisis. It's, it's too late when you try to get yourself ready. So I think that's the message. It, it's, it's interesting to do your, uh, conversation and the conversation with Ochsner.

Uh, on my timeline, I, I just did them 15 minutes apart and Ochsner, he just sort of looked at me and said. You know, we have a crisis every, every year, if not every two years. 'cause there's a hurricane waiting to, waiting to hit New Orleans. He goes, so yeah, we had capacity, we were ready. And, and you just rattled off, you know, from nine 11 till today, there's been a, a fair number of things, but what, what specific solutions have you put in place that others may benefit from?

Um, is there a specific solution that, that you think is, uh, relatively creative for, for, uh, that others could con consider? So several things about, you know, telehealth. I touch base, you know, we, our telehealth and we, we, we had, uh, um, invest a lot on digital. Um, and that's just not tele, uh, telehealth, but digital.

Um, so that we, um, we, it, it was, um, clearly we pushed a lot of video visits. So both on, not only we, we had a virtual urgent care already in place, but the volume went up. Um, really crazy and we had to prepare our clinicians to matriculate and so that the technology we built was very easy. Uber like, you know, that physician can go and take a shift and be virtual and we prepare, so we wouldn't expand a lot of physicians who can do a virtual session.

And then also on ambulatory side, we moved a lot of visits, virtual. And part of it's because of the reimbursements is feasible. And then serving our patients in the community who don't want to come to the doctor's office and we really be booking a lot of video visits and our volume would have thousands fold, which is great for community and, and our physicians to be, um, you know, serving our patients in their family.

Um, on the inpatient side, being able to use telemedicine between physician.

And then, um, because we have such an integrated EHR, we have one, um, EHR across our health system, um, really, um, making all the protocol changes and that the whole health system gets that, um, in one go. So, um, you know, we, in that sense, we've been lucky that we've been integrated our EHR across the health system.

Everything, not multiple system in different health, our hospitals. So that allows us to be very nimble and we'll make a change to that. And the other piece is really analytics are, I'm sure every institution leadership want the data to be able to decide how many patient came through, what was tested. So we quickly a dashboard.

Analytics and dashboard will really deliver to leadership the dashboard They need to, uh, have information at their fingertip to make decisions. So all of these things, I think you've got to, um, you know, kind of move in the same, all in the same cylinder and get every team resources it to uh, kind of deliver these needs.

Uh, where you, uh, your leadership needs information, needs data, real time to make decisions. Yeah. What, um, I was, I was gonna ask you about your build team, your EHR build team, and if they've been asked to do anything specific. And I was gonna ask about analytics, um, from an analytics standpoint. Let's delve into that a little bit.

So, did you, uh, you know, what kind of things did you put on the dashboard and what kind of, uh, things are you being asked for in addition to dash dashboards from, for, from your analytics team? It's clearly the, you know, how many patient come through the door, um, who's in ICU bed, who's in recovering, who's been tested, uh, the condition of different patient volume across each hospital, a number of visits, um, you know, um, um.

You know, ventilator counts, um, you know, so a slew of things that leadership wanna look at it real time, every day, every moment. And to be able to have that information. So, um, those are the main things. And then we also trending the data, seeing every day how things, trends across different, our emergency.

And, um, and then inpatient settings and then clearly telehealth volume, um, and, uh, very other aspects that we are measuring. So, you know, and we, we have that one interesting. I would tell people that advise is as you developing these dashboards quickly deliver them metrics and add new, new next one. So you don't have to build all of them at once and deliver.

So just as much as you can deliver and let. And clearly partner with hospital operations and leadership and conditions to make sure that the data is validated quickly and makes sense, and then, uh, you know, deliver these metrics, right, you know, every day because in leadership and the metrics, and be happy.

And so don't wait to do everything, you know, get, get to the main things and then keep iterating. . Yeah, absolutely. Um, your, your build team and your, uh, you know, your build team around your EHR, I mean, there's a whole bunch of codes being thrown at us. There's a whole bunch of, uh, you know, potentially different screens tracking for, uh, O-N-C-C-M-S and others.

Who, and, and CDC, uh, who, who want information. I mean, have you, has your team been busy trying to incorporate that? What kind of work are they doing right now? As the team. So the team is very busy. Um, one we try, first of all, we most focus on how our serve our patients, um, and listen to our clinician, their needs about what kind of, what kind of, uh, information they need on, on our EHR screen to solve.

We deliver the integrated screen that has a good level of information. One of the things we, a good preview that our in. Physician also work on the floors. Now they're doing shifts. Uh, so it's getting good information, insight about what's happening and how are people looking for information and what, what are some of the things that we can adjust.

So that's been very helpful because these are our clinical mplementation and information. Part of it is actually also doing shifts on the floor. So that's, um, and also doing some telemedicine visits. So

continue to. You know, work with states and, um, uh, federal government and making sure that we, providing the data we need and also our ER vendors as well. Yeah, I mean, when you're in the thick of it, it's, it's important to be focused on the, on the clinicians, on the patients and, and serving them well. Uh, you know, last question, and I appreciate all the time you've given us, you know, what's, what, what's one thing in the prep process that you wish you had done?

Uh, earlier on? You know, there's some systems that are getting ready for a surge. And, uh, maybe they have a little bit of time to, to do something at this point. So, is, is there one thing you wish that you had done maybe earlier in the process? I, I'd be very honest, you know, and I know it sounds, you know, a little strange, but no, as I said, we've been having this structure in place, so we exactly knew when we connected how to start.

Um, you know, uh, organizing team reacting and making sure that people understand. And then also, you know, um, taking care of the employees themselves and making sure that they have access to the system. Um, you know, and, and. And they're safe. So, um, I, I think that, um, you know, you, you have to be prepared. You have to have a structure.

So if you have not had a structure in place about communications, you know, we also make sure that you have in that place so you can communicate very rapidly with your team. And there's a structure. So one thing I would advise people, if they have not that in place and they don't know, oh, what. How do you, people can engage how the information gets estimated?

How do you communicate? So for example, when we prepare for, um, people working from home, some, uh, non-essential staff work from home, of course our clinicians working in the hospital. And um, but um, you know, we immediately have to. Give people information about, hey, if you are using your, your computer from home, this is, this is a helpful hints and tips.

And how do you use WebEx effectively? We kind of estimate information very quickly to people so that, you know, some people may not have used WebEx or uh, zoom technology, um, in a while, and then we. Quick tips and also a lot of these sessions get very large and people have a different way to manage and okay, how do you meet people quickly so that you get, people can need it?

Like little things that actually, people really appreciate that you kind of give them a hint before. So have those things, information prepared, um, so that you can make. People will stay productive. Um, so those are some of the advice. I, but you have to have a structured place, you know, if you don't have a, a emergency call number that everyone can get on, and then second notice, then you have a bigger problem.

So for us, it's, if I wanted to get my leadership on a call, there's no, oh, here's a number people know is an emergency call, AP one we call it, and everybody gets on the call. Yeah. It's in everyone's program. Everyone's. You know, I, and you know, again, I think you guys have benefited from, uh, I mean, it's, it's hard to say you've benefited from going through disasters, but you, you do benefit from going through them and, and learning things and, uh, and being prepared for these kind of things.

And I, I appreciate you, uh, bringing that experience into, uh, in, into this crisis and, uh, being a part of, uh, of sharing that with the, uh, audience. I really appreciate it. Uh, thanks again. Yeah, my pleasure. I really appreciate your time. My pleasure. Thank you. That's all for this show. Special thanks to our channel sponsors VMware Starbridge Advisors, Galen Healthcare Health lyrics and pro talent advisors for choosing to invest in developing the next generation of health leaders.

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