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 Welcome to this week in Health IT News, where we look at the news which will impact health it. My name's 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. I. I wanna thank Sirius Healthcare for sponsoring this week's shows to discuss and share best practices around preparedness, uh, around Covid 19, uh, and the great work, uh, that healthcare is doing right now.

Uh, this week, as I said, uh, COVID 19 discussion with our special guest Drex to Ford. Uh, good morning, Drex. Uh, how are things going, where you're at? Uh, good. Um, I am in Seattle, which is kind of the hub of the, uh, initial . Covid 19 outbreak. Uh, things have gotten very quiet here. Uh, as far as things that are happening outside, obviously.

Uh, this weekend the governor, um, announced that they were closing all the bars, all the restaurants. You can still do, carry out food. Um, you know, no gatherings more than 50 people. It, it, uh, you know, it, we're not locked down, I wouldn't say, but we're getting there. We're getting closer and closer and closer and all of it towards sort of the effort of flattening the curve.

Um. A lot of challenges here in some of our health systems already with supply chain stuff and having beds full. And so we're, we're getting there. Yeah, I mean, you just hit on two things. One is it seems like the, the federal, uh, is essentially leaving this up to the states, and so you saw New York, I think New York, New Jersey, Connecticut, just come out with, they are taking those same measures, and I think California's taking those same measures.

Um, as well, but if you look at a map that would make sense given, you know, the. There are, are deeper red than some of the other areas of the country. Sure, sure. The places where the blooms have really happened, um, and, and spread quickly. Uh, obviously those are the places who are maybe taking this more seriously than other places.

And so are putting these, um, these situations, uh, you know, these restrictions into place. Um, for the places where the blooms haven't happened, I, you know, I mean, I don't know what. I don't know what to say except I kind of am the negative guy in all of this. I don't think this is going to, uh, go very well.

And so, uh, you know, uh, uh, go, go earlier rather than later. Don't be afraid to be, um, uh. Overly cautious in all this. Yeah. But that's, that's our background. Right? Prepare for the worst and hope for the best. Absolutely. Yeah. We overbuild, we, we build networks that are redundant and triple redundant. We are always coming up with the, you know, this is my primary, this is my backup.

You're right. We are plan B people. That's kind of how we've, we've been raised our whole career. Yeah. The um, the other thing you mentioned was supply chain shortages. I saw. And again, I can't verify a bunch of this stuff I saw on social media, which is again, one of the best sources for information at this point, unfortunately.

But it is. Um, but I saw shortages in, in Boston, uh, some of the hospitals were actually calling to the community to supply things like masks and other things. N 95 masks. Yeah. Um, and I don't know if that's accurate. That's the problem with social media. It's not a verified source. Right. So, so you're, you're counting on some of your peers to, to verify that, but.

Um, but again, supply chains. Oh, so that's, that's how we're gonna address this topic. So, um, we could, you and I could talk for the next three hours on this, but we're gonna try to, to organize it and here's how we'll organize it. Got it. Challenges we're trying to address, uh, and we're gonna break it down into two categories, obvious challenges.

This is the stuff that everyone in health it is gonna go. Yeah. I mean, we're gonna do these things and then the not so obvious maybe the things we're not thinking about. And so I'll throw out the first obvious challenge and that's, um. Communications platform, you want to be the source of information for your community, um, around the pandemic that has impacted them.

So when they're doing a search in, I'm in Naples, Florida, you're in Seattle, um, you know, I want to hit the local health system or as a health system, local health system. You want to be the one that I hit. And so I go to your site, I see a blog, I see articles, I see reassuring, um, videos and posts from physicians.

I see instructions on what to do. Um, uh, but not only that from a communicating with, with the community at large, but also the community internally. There's an awful lot of information to coordinate within the four walls of the hospital. There's state and federal, uh, guidelines coming down. There's CD, C, there's, um, uh, there's just a whole host of things.

People within that, it is the responsibility of health it to organize that information in a way that people can get it at their fingertips when they need it and all those things. So that's one of the obvious ones. How about, how about you? What's, what's, what's another obvious one? I mean, I think you, you know, that's a really great, uh, track.

Um, you know, talk to your marcom people, pull them into this. Don't make this about a technology thing. Help them decide what they need to communicate when and how they need to communicate it, and then provide them the infrastructure that they need to do that. If you're using Slack inside your organization or using internal web portal, whatever the case may be.

Figure out how to make it work. This probably isn't the time to try to stand up brand new capabilities around comm uh, but, but it's clearly a very urgent, uh, component of managing a crisis. Well, and let's drive that. Let's drive that. And by the way, on this, what I just want us to do is identify 'em. So communication pla let's, we'll, we'll keep going through 'em and then, and then we'll dive deeper into them.

But I think that's an important point that you just made. Is some people are gonna be tempted to start standing things up, uh, very rapidly. And there's some, in some cases, you're gonna look at things and go, look, we can go to the cloud. We can stand that up. We can do this. And there's, there's not a lot of considerations.

But you and I have both worked in healthcare. We know there's, there's significant considerations. There's very few systems that sit on their own. If they do great, stand 'em up in the cloud and away you go. But if they require any integration at all, any planning. Uh, it's, you, you're probably too late.

You're, you're actually, what you're doing today is planning for the next pandemic, whenever that might be. Yeah. Yeah. Hey, the other thing, when you talk about maybe not so obvious, right? Um, especially when it comes to cybersecurity or when it comes to communication, I would say, you know, think about cybersecurity and all of this.

Um, there's a lot of calm coming out. There's a lot of stuff that looks super attractive to click on. Emails. Here's the latest updates for your zip code. Uh, the boss is getting ready to, um. Make an announcement, make sure you click on this website to, to register for the webinar that he's gonna be doing at, uh, you know, four 30 this afternoon.

I mean, the, the scammers are scamming man, and they are really, really good at it. So I. Be really thoughtful about talking to your teams about cybersecurity. Make sure you're doing all of the managed detection and response stuff that, that you should be doing to, to make sure that you're in a good spot because they're not, they're not slacking off right now.

Yeah, and I'd, I'd love for them to find those people after this is done, uh, track 'em down and then I, I, I would like them to institute the stocks just on the outside of Costco. And just let people throw stuff at 'em. Yes. I think that would be a great idea. a great idea. . I don't know if anybody, alright, so here's a couple of the other obvious, uh, you know, pandemic management tools.

Uh, you're gonna need EHR, dashboards, screens, you're gonna wanna know, uh, equipment, usage, beds, uh, rooms, people, you know, what, which of your people internally have come down or are ill or not coming into work. Uh, so anything that's a. That is a, um, you know, a, a resource, a limited resource that is potentially gonna be needed.

You're gonna need those management tools and dashboards. Hopefully we should have all the skills to stand this stuff up. What's, what's another obvious one that you're thinking about? I think when you talk about people who may be sick or maybe have changed roles, you and I had a conversation earlier today about

Uh, CIOs who are also clinicians who may be pulled out of their CIO clinician, uh, CIO roles and put into clinician roles, moved back into the ed, moved back into, uh, the ICU, um, that having an org chart and hopefully you already have sort of a, a human. Continuity plan. What happens when this person isn't available?

Who's the backup and then who's the backup to them? That stuff should be documented and easily accessible so that if I need to talk to the CIO, and it turns out the CIO is, you know. Neck deep in PPE, in the emergency department, trying to take care of patients that, um, there's a backup plan. Who can I talk to?

And do they have the authority to make these kind of decisions? So put that kind of structure together and put it out there now so that it's easy to find. Yeah, and we'll come back to that. I think, you know, um, things that allow for the clinicians to keep a distance, the self-diagnosis stuff is awesome.

If we're telling people to, to self quarantine, stay at home, do those kind of things, uh, we still need to give them ways to figure out, you know, what their status is. Chat bots, we've seen, uh, proliferate as a result of this, which is fantastic. We've seen phone banks get, uh, expanded significantly or even repurposed during this time.

Mm-hmm. I mean, you don't need to be doing a lot of collections right now. If you want to get a black eye on your health system, be making collection calls right now. That's, that's a good idea. So you have a whole bank of phones that you could, uh, redirect to clinical purposes during this anyway. So self-diagnosis, uh, supporting drive-through testing and telehealth.

I've heard a lot of people standing, those kinds of things. Um, and I think one of the things that's falling through the wayside is we have a bunch of existing work, like chronic patients. Are non coronavirus type patients, but they're chronic patients that we continue to to care for. And um, and I think that's one of those maybe obvious, maybe not so obvious, how are we going to care, uh, for them?

And I think the last one that's pretty obvious is just work from home. Has really, uh, one, one last, not so obvious. So you just got your internet back just prior to recording this show, , right? Uh, right. And, and you and I are sort of trained this way, but there is this sort of escalation of problems that can happen, uh, over the course of time where we just put all these people at home for, and, and now these platforms for

Like Zoom and other Zoom is, I think on a scale just fine, but um. You know, internet service providers, whatever, that they could break for sure. Yeah. I mean, I think you look at, um, so there's sort of like different levels of this, right? One of them is yes. I wanna make sure I have access to Zoom, because that's probably how I'm gonna do a lot of my meetings.

But I'm also, also, if we have teams, I might wanna have teams as a backup. And then I might also wanna make sure that we have WebEx accounts available for at least some select people should something fall apart. So kind of at each of these levels, you wanna make sure that you've got it. Uh, got it set up.

You're right. I just had a problem with my internet going out. Now, I don't know exactly what the problem is, but I have a fair guess that probably somewhere in my neighborhood there's a bottleneck because the kids are home and they're watching Disney and mom's screaming . Uh, you know, music on, uh, apple Music and Dad is, uh, you know, I don't know, doing whatever dad's doing and, you know, right on down the line.

And suddenly this stuff is overwhelmed. I'm sure that there are peaks in network infrastructure in good old plain old internet stuff that's, uh, that we're bumping up against now. So, you know, they're also scrambling for new equipment, expanded capacity. All of those kinds of things because they're seeing traffic like they've never seen before.

I, I'm looking at, you know, the way I was gonna do this, or one of the things I was considering was I can tether my phone, you know, to my computer and use regular cell minutes. It may not be as quick or as fast, but it's things like that, the, again, I think we're always a plan B, plan C, uh, kind of guys, and, and whatever you do during this crisis.

Think about your plan B and plan C and what, you know, what's your backup? Because your primary may not always work. Alright, so let's talk solutions. We'll go, go down this list. So pandemic management tools are, do so, um. Do you think the EHR providers are going to do this, or do you think we we're just taking our build teams and saying, look, build out this dashboard.

We need to look at constrained resources. Um, let's talk to the physicians, determine what resources they're concerned about. We'll build these out and build 'em into the workflow. Or are we expecting the EHR providers to provide these things? Yeah, it depends on the size of the organization, right? I think that some of the smaller places, if you think about

You know, 60% of their country, uh, 60% of the country gets their healthcare from, uh, small and rural hospitals. Um, those folks, I mean, I can tell you . Uh, you know, sitting down in eastern Washington with some small hospitals a couple of weeks ago, they were poking fun at each other about how did you get four people in your IT department?

I only have two people in my IT department. Those guys don't have build teams and they're not building anything that isn't . That doesn't already exist or isn't coming from a vendor if you're at a big health system. I think we already see good examples of that, uh, where organizations are building their own, you know, pandemic dashboards and dashboards for the community and things like that, that they're sharing both internally and externally.

But yeah, analytics is gonna be a huge part of this, seeing what's happening and where it's happening and, you know, trying to decide how you make that move to sort of. Cut it off at the pass, whatever that turns out to be. Yeah. So if you're an EHR provider right now listening to the show, and I know we have.

Just based on listens. I know we have a lot, uh, in Boston. We have a lot in, uh, a certain place in Wisconsin that listen to the show as well. I, I think it's a matter of, uh, opening up the sharing platforms, which they all have. So if I'm developing something in Seattle, yes, they can easily be deployed elsewhere.

Uh, and you know, there are some large health systems on Meditech, which runs a lot of the smaller health systems, and I know they have the capacity to move some of this stuff around as well. I think that you know, if you are, if you are a vendor in the healthcare world. Um, part of the reason, at least I would like to believe, and I, I know because I've done this for years, part of reason, the reason those companies are in healthcare is that they are also addicted to the mission.

Just like all the rest of us. It's all about better, faster, cheaper, safer, easier access care for patients and families. Yeah, those companies have made a lot of money in the last few years. Uh, this is a great time to . Tip back in your chairs and say, what can we do to help right now? And put your teams on that.

And that may mean spending more time with your customers when they don't have time to try to ask those questions. Or it may mean just trying to come up with some stuff on your own that you know would be useful, but put your shoulder against it. Everybody's gonna appreciate it. Yep. Absolutely. Alright, the next one is communication tools.

And I'm really passionate about this. Um, and so I, I have a handful if you have some. That would be great. So, uh, UW in your neck of the woods, put out a document sharing site. This is really around, I. Whole Health System response and Health IT response. And it's, uh, covid-19 dot uw medicine.org/pages/default.aspx, which means it's probably a SharePoint site.

Um, and, uh, a really good outline. It's really designed not for the community. It's designed for the internal community. I like the fact that they've shared it with, with all of us, so it becomes a really good resource. But that's sort of on the side. I, I want, what I wanted to focus on is. Mayo Clinic has a really good page.

Uh, news Network dot mayo clinic.org/category/covid 19. We'll come back to the naming. Uh, Stanford Healthcare is a good one, Stanford, and actually a lot of people do have good ones. Uh, some of the ones I hit are not so good. I'm gonna cover some of the things that I find to be good and not so Stanford healthcare.org stand, uh slash stanford dash health.

We know how to do redirects. Will you make this stuff easier to get to? Yeah. baptist.health.com/covid 19. That's what it should be. And not only should it be covid dash 19, it should be C Ovid 19, it should be Coronavirus. They should all point to the same page. So no matter what people are doing, they should be able to find this thing.

So that's the first thing. Second, and I'm sorry, I'm gonna go off on my little tangent right here. It's alright. Go ahead. It needs to be above the fold. It needs to be in the banner. Some of you are putting it in your news section, which is like three quarters of the way down the page. I'm not going there.

It needs to be at the top. It needs to be a nice little red banner. I see it. I know it's there. Um, use your design team. There's, there's a lot of ways. Some of you don't have designers. That's fine. Designers are real cheap online. But have them look at your page colors, design, communicate things. The other thing I like about Baptist health, some people just throw a whole bunch of links and a whole bunch of resources.

That's great for the people in your community that are, you know, college educated and, and all that stuff. Um, but you have to consider the entire community. You have to communicate in a lot of different ways, through pictures, through a nice, easy to understand video, a nice, easy to understand, uh, text. Um, those kind of things know how it looks on the mobile device.

Um, I, I would say the other thing I liked about Baptist Health is know, know the questions people are asking, right? I should be able to hit it and very quickly know, how do I self-diagnose? How do I, uh, how do I diagnose remotely with the help of a physician? How do I get testing without going into the hospital if I need care, where do I go?

Um, if I don't have coronavirus, but I have an appointment for something else, what am I supposed to do? Who am I supposed to? I mean, there's a whole bunch of questions that you, you could just, you know, look at the searches people are doing on your website. You should have a way of capturing that, and you should be able to turn that into a page that answers those questions very.

Quickly. So those are, those are just some of the things that I, I'm seeing on some of these pages and I'll, I'll let you comment on that. No, I, yeah, you're right on the money. Right. A dozen, a dozen questions on an FAQ page, uh, probably will answer 90% of what people are coming to your page for. You don't have to be perfect.

So you know what those dozen questions are. I mean, bill just gave them to you. Come up with the answers to those for your health system. Put 'em out on a page, put the banner at the top of the, you know, like you said, above the fold. Don't make 'em go search for it. Give it a really easy to use name. You, I mean, you nailed it, bill.

That's that's exactly, that's exactly it. If you're gonna come with a community, if you're gonna communicate with the internal staff, you gotta give them really easy to use. Really the easy to access stuff. Alright, so I'll give you the next one. How do we scale up self-diagnosis? So we've seen chatbots and call centers being two, the two of the mechanisms that people are offering, and maybe you have some others, but how do we scale these things up?

Yeah, I mean, chat bots and call centers are, are definitely good ones. Um, you know, I think I, I get a, I've gotten a lot of calls this morning and this weekend, uh, as folks have continued to try to do things like stand up, drive through cabanas, and then figure out what do I do in my EHR to add a new location.

How do I get equipment out there and what are we gonna do to make sure that the wifi access that we just put in the parking garage for this is secure and, you know, right on down the line. So, uh, you're definitely being asked as ACIO and as is the CIO's team to, you know, stretch and be flexible and.

Quickly that you've not been able to, you've not been either asked for or allowed to do, uh, in the past. And so, yeah, you, you, you definitely gotta look at all these other channels. Alright, so as a quick tangent, uh, let's assume I'm standing this up in, uh, a Walmart parking lot. It's the biggest parking lot in our community.

We set up the cabana. I have to get them internet access. Uh, to that location. I, I assume you're looking at, uh, maybe a partnership with Walmart to get on their, uh, wifi would be one way. Maybe the ISP has a way of doing it. And then I guess, uh, I guess, uh, mobile cell is, is another way. Are are there other ways that you would get them wi uh.

Access. Those are the three ways that I would think of. Right. You know, right off the bat. Um, so how do you, whenever you do that, how are you gonna secure it Exactly. So make sure that, uh, you know, whatever you've done from the perspective of a virtual private network or some, some kind of tunneling to make sure that you're secure, uh, don't forget to do that.

The, the problem that happens right now in a lot of these situations is that we're acquiring new gear, we're putting new gear into place. Either, uh, to send people home, to work from home, uh, to stand up, drive through cabanas, whatever the case may be. And we're buying it and we're deploying it really quickly, and we're not running it through our normal protocols around cybersecurity.

So, you know, make sure that you're doing all the things you should. Don't leave the admin, admin password, you know, out there. Don't, don't let yourself get smoked on something that seems. You know, painfully obvious. I know it'll take a little more time, but you just can't. Lay landmines that, you know you're gonna step on later.

Um, take, take a deep breath and, you know, be decisive. And, you know, this is a perfect time to cut through red tape if you think there's unnecessary red tape, but a lot of that red tape is there for, for a reason. Don't, yeah, no, absolutely. Uh, so are, uh, so two types of equipment we're probably sending out there, we're probably sending out laptops.

I don't assume we're sending desktops out laptops with VDI. To get to the ER and maybe some biomed devices. I don't know. Um. Is, is, is that what you're thinking a cabana looks like? That's a good, that's a good question about the, the biomed devices. Um, I don't, you know, my, my certain, certainly my impression right now is that they are probably, um, collecting samples.

I. Then there's somebody who's a runner that's taking them back to the lab to either be processed or shipped. Yeah, that makes more sense. Um, I, I can't imagine that they're doing, you know, actual onsite testing. Uh, at this point. I've talked to health systems, you know, the whole process kind of in the beginning was you had to ask the CD, C for, um.

For tests, and then they had to ship 'em to you and then you had to, you know, do the test and then you had to ship 'em back to the CDC and the CDC would send you a result. And that took a while. And then it sort of expanded into, there were other places you could get the test, like the University of Washington came up with a testing protocol and testing capabilities, so you could send it to, uh, you know, the, the local university and, and get results back.

Uh, CDC has now decentralized a lot of the stuff to. To public health organizations throughout the country, and you're seeing health systems, according to one that I talked to at the end of last week that are ordering their own equipment that hasn't been, hasn't been arrived, hasn't arrived, haven't hasn't installed yet, but their intention is that they're going to do their own testing inside the, the, the hospital.

So it's getting better and better. You're getting closer and closer to being able to sort of do the test and get the result back pretty quickly. That would be amazing to have the testing in the Cabana. I don't think we're there yet. Yeah. And we're seeing, we're seeing that those timelines start to come down.

I saw Roche, uh, was talking, you know, bringing it down into the minutes category versus, um, I. You know, hours to get the test back. Yeah. Uh, but, but again, you have to manufacture that equipment, get it out, uh, all that. It's the reagents, right? There's lots of stuff that goes with this here. All right, so let's talk work from home.

And I'm gonna give a little credit to Lee Milligan on this one. Uh, who I interviewed recently for the show, uh, that's gonna be released pretty soon. Um, he, he, he said, he goes, look, I, I just asked my team real quick, three buckets of people, people that can go home today and work from home without any problem.

Then he goes, I need a second category of people, people who can work from home but need X, whatever X is. They need a computer, they need internet, they need AVPN, whatever. Tell me who, who that group of people is and what they need, and get that list together. And then the third list is, cannot and will not work from home.

Mm-Hmm. and I, I thought that was just real. You, you can count on a, an, uh. Uh, an ed doc to come up with something like that. It's like, let's triage this really quickly. Yep. Give me this list. And I, I think that's a good, that's a good approach. 'cause that list is gonna tell you the things that you need to stand up very quickly, uh, in order to do this.

Um, but let's talk a little bit. So one of the things that we talked about a little earlier is. Uh, you know, one of the things that people are sort of throwing out there is, well, you know, you could just do this vdi, I stand this up real quick and, and be, uh, be able to, to do this. I'm a former CTO and you're, you're, you're extremely technical as well.

Um, VDI environments. How, how much can we, how much can we stress these? How much can we scale them? Um, I mean, what, how do we determine how far we can push these things right now? Yeah, I think, uh, when you look at organizations who run VDI internal to the organization, they have some pretty good ideas about what their capacities are and what kind of concurrent number of desktops they can run.

Um, they probably have some good experience with that, and they may actually have the capability of being able to tap their vendors and scale up pretty quickly, um, if they've already taken those steps. Right. Some of the challenge in this is that if you've just, if you're deciding today that you're gonna try to scale up VDI, when you call your vendor.

They may have a challenge supply chain wise, getting you what you need tomorrow. Uh, so hopefully you've already taken those steps. Likewise, I think if you've done stuff in the cloud, if you're doing VDI and Azure, you're doing VDI and AWS or something like that, um, you've, you have the kind of experience that you need to be able to scale.

You should be able to scale up pretty quickly. Um, but. For everybody else. Uh, this, you know, try trying to start AVDI program right now in the heat of the battle. Might be, might be tough. Yeah. And VDI gives you the illusion that it's limitless, right? You just, oh look, it's all I have to do is go to my workstation and provision this and provision this.

So, you know, we had. 6,500 VDI, uh, clinical workstations at St. Joe's when I left. Mm-Hmm. . And, um, we had to solve two problems. One is we had to get all those apps to run on the VDI environment, and then we had to scale. So we, and we did, we worked our way through both of those things. But at the end of the day.

A-V-D-I-A environment still runs on a physical set of, uh, you know, hardware, um, uh, hypervisors and you name it. And if you are like ordering your equipment from Dell today, I guarantee you that supply chain isn't gonna drop those things in your data center tomorrow. I. Yeah. And the other, the, the other misnomer is that Azure is limitless.

AWS is limitless. They're not limitless. I've, I've, I've had people tell me they've run into constraints in specifically in some of the Microsoft data centers that just, they, they didn't have capacity. They had to build out capacity. So it, it's, it's a misnomer that cloud is unlimited. It has the potential to be unlimited, but they have the same constraints.

We do. It all runs on something. Yeah, I mean, I think, you know, when you talk about, okay, in Zoom or WebEx or Teams, that's an application constraint, but now we're really talking about things that probably, you know, would be considered in the utility. Uh, maybe not a utility, but kind of a utility like, uh, category.

So whether it's does your internet provider have the capability to provide all the bandwidth that they need? Do the cloud service providers actually have all the capacity that they ? You know, all the capacity that everybody's gonna want to eat right now. At the same time, you know, the, the kind of running joke is that you have to build the pipes in the condo.

You know, in the, in the, the big building, you have to build it so that everybody can flush the toilet at like seven 30 in the morning and they're dealing with the same problem. Uh, if it's VDI. Um, you know, at 7:00 AM everybody's spinning up a desktop. That doesn't mean that you can't support all of them, all of them later in the day.

It's the same flattening the curve problem that we have with Coronavirus, right? It's. I don't want everybody to show up at the same time. 'cause you overwhelm the infrastructure that we've built. So when you're thinking about analogies to, to what we're dealing with now from a healthcare perspective, that's, you know, that probably is a good one too.

So let, let, let's talk cybersecurity real quick. Is it, is it just a matter of. We already have the protocols in place. Just make sure you follow the protocols. I mean, that's what I heard you say earlier, or is there something else? Anything else we should be considering? I think, you know, it's, it's about following the protocols, but it's also the reality, uh, that I think a lot of organizations don't necessarily have all the people that they need today.

To be able to do the work that we're asking them to do around cybersecurity. So in some cases we see it's not cybersecurity professionals, but other IT people who are carrying a lot of the cybersecurity load. That distr, that distraction just on its own, uh, can be a challenge to cybersecurity. I was hired to do networking, but I'm actually doing a bunch of cybersecurity stuff as an additional duty when the.

You know, when the, the balloon goes up, when all this stuff is going on right now, and those folks are really, really focused on getting their networks expanded and getting stuff out to the cabana and doing all of that. They have a tendency to slide these things onto the back burner around cybersecurity, and that's, that's a bad situation.

So I would say this is a great time also to start thinking about, you know, all the places that you can think of that you might be able to offload to a partner you should think about. Is this, you know, is this a good time to try to do that? If it's simple and easy to do and not super complicated, as you were saying earlier, right?

You, you don't, you don't wanna try to do something that's gonna turn into a giant project. But if you've got something you can offload to a partner, whatever it is, cybersecurity monitoring, something else, that should be part of your planning process right now. What can I get out of my hands so that my people can focus on the important stuff?

Yeah. So let's talk about that. So, you know, if you were to ask me a week ago. You know, what are you doing about non-essential projects? I would've said, you know, I'm gonna, I'm gonna let 'em go. But by Friday, if you had asked me, what, what are you doing about your health it non-essential projects, I would've said, uh, not only am I putting all those on the back burner and putting them on hold, I probably would've put a significant number of.

Of mainstream projects on hold and I, Mm-Hmm. , you know, now that I'm talking to some CIOs, I think they're, they're, they're also getting to that point where they said, you know, Hey, we're, we're in the middle of a merger and we just took that entire team off the merger work. They are now focused on, you know, building out screens, building out dashboards and, and things.

They, they were building out new capabilities for, for the merged entity. Uh, where, where would you be at? I mean, I think I'm, I'm at a point now where I'm, I'm probably looking at it going, look, the, the worst is probably gonna happen over the next two to three weeks. Our preparedness time from an IT perspective was.

Two weeks ago to probably the end of this week to really have our things done. So I think sometime last week that the thing switched in my head to say, no, no, this is an all hands on deck. Let's make sure everybody in it gets all these things stood up. And maybe that was even late to the game. You probably would've flipped that switch maybe two weeks ago.

Yeah, maybe I, you know, I think right now my advice would be create as much capacity as you can. So if it's not essential, stop doing it or, you know, put it, put it on the back burner and let it simmer so that you've got capacity to do the things that you're, you know, you're being asked to do now that are mission essential to serve patients and families.

Um, don't be afraid to, um, you know, this is an opportunity to. Be decisive and be bold. Uh, you, you're going to have to force the issue with some of the other people around the table around. The need to build capacity to be able to serve the mission at hand today. Um, uh, you know, you said you think it's gonna be, you know, the worst over the next couple of weeks.

Uh, I think, or it's, you know, it's gonna ramp up over the next couple of weeks. I actually think it's gonna ramp up over the next several months I think. This week will be the week that we will see the real upturn in the hockey stick. But I think that upline is a really long line. So we have to be prepared that this isn't, this is unlike any kind of.

Crisis that we've faced before. You know, a lot of us have gone through, um, storms or tornadoes or hurricanes or other things like that. I've been, you know, fortunate that I've been in combat and shot at and missed. But, um, those things have a definite amount of time. They last for a short period of time.

You're a crisis manager for, uh, a week or two weeks or a month or something like that. But there's light at the end of the tunnel. . Um, this is a long game and I think, uh, we have to think about this amount of effort and this kind of management and prioriti prioritization and reprioritization. As a much longer game than we're thinking of today.

This is probably where you and I get in trouble 'cause neither one of us are clinicians, but, uh, but we, you know, you have to determine who you're gonna trust in this. And so I trust numbers and I trust people with good track records, right? So, so Fauci has a good track record. Um, and, and he's saying things like exactly what you just said, which is this ramps up, it ramps up really.

Big, this is why we're doing the social distancing. This is why we're shutting down bars and other things. Uh, this is why we're limiting travel, um, because it, it flattens the curve. So for those who don't understand, flattens the curve, if, if this thing does a hockey stick and goes directly up. We do run out of beds.

We run out of, you know, ventilators. We run out of all those supplies, all our supplies, you name it, we run out of all that stuff. But if it happens over the course of a couple months, if we're, if we're successful in flattening the curve, we're gonna save a lot of lives Just. Just because our health system is gonna have the capacity to manage it over time.

It's the, it's the age old, uh, you know, supply and demand. Um, and so if we can manage that over time, we're gonna be, uh, we're gonna be better off. So, you know, so who are you gonna trust? And, and, and, and what do the numbers say so we can look at China and trust the numbers somewhat. Now understanding China is a very different place than

United States. I mean, they, they have a different form of government, so they were able to lock down that city and put up guards and make people stay in their houses and those kind of things. I don't think we're gonna get to that point because I'm not sure we would respond real well to that. Uh, and it's not our form of government.

But with that being said, we have done the social distancing. We have done those things. In an effort to, uh, to flatten the curve. Um, but the numbers would indicate even with those measures that we are going to see a significant number of cases. Um, and, and so this is where we get to the prepare for the worst hope for the best.

I mean, what's the worst that, the worst that could happen if you over prepare is. Is good, right? People don't show up. I mean, you know, some, somebody's gonna make fun of you, right? Oh, you, you were crying wolf and you, you know, you were over-prepared. Always better to be over-prepared than under-prepared, right?

So, you know, say what you want about the Chinese. Uh, they've, they've flattened the curve. They also, I think. Probably really understand that as soon as they start to release some of those people from their homes to go do things, they're going to bloom again. This isn't the end of it for them. They built a bunch of hospitals and they shoved everybody in their houses and they turned everything off because they needed to manage the capacity until they can get everybody to a vaccine or they can manage a, a certain level of sickness that doesn't overwhelm the, you know, the whole system.

The other thing about supply chain too, we gotta think about is that a lot of the stuff that we're using comes from China. And so the first guys in line for stuff that's being manufactured in China are the Chinese. They're gonna get it first. Um, they're doing a really great job of managing this. Uh, but you're right, they're taking some really harsh draconian measures, uh, to get there.

Uh, I don't, I'm with you. I don't think, we'll, I don't think we would respond. To, to measures like that very well. But, um, but we're gonna have to think really hard about how to flatten that curve. Wow, we've covered a lot of stuff. Let me give you one last thing. So in terms of the chain of command, and one of the things I'm telling my clients is, you know, who is your trusted?

Number two, know who that is and you might as well know who your trusted number three is. Um, you know, to be honest with you, the recovery rate on this is really high in, in certain age demographics. So, um, it may not be that big of a deal. You may not think it's that big of a deal, but if you're ACIO physician, as you talked about earlier, and you get drawn in, you're gonna need a, a trust number two.

And I don't think if you're working the whatever shift you're working, you're gonna wanna work a double shift as ACIO and. As a clinician, I just don't think that's a good place to be. And uh, and you just have to think through that. Who's gonna step in? How's the team gonna respond? Are they ready to respond?

And you know, one of the things I'm, I'm offering my coaching clients, and I'm sure you would step in and do the same thing, is if, if your number two has to be moved into those kinds of roles, they could easily, you know, call me. They could call you. Sure. We'd be more than happy to support those people as they're trying to figure it out.

'cause it's, you know, it's, you wanna talk about combat. You know, by fire, I mean this is, this is literally it. They would be stepping into a, uh, a very challenging situation as their first. Uh, foray into, uh, into the lead, lead role. So, um, you know, we're there to, we're, we're there to support, uh, you guys.

We'll keep doing it with information, we'll keep doing it with shows. Uh, keep interviewing CIOs, see what the best practices are and getting 'em out there and then. Uh, by all means they could reach out to you, uh, very easily to do and reach out to me as well. Yeah. Yeah. Thanks for doing this bill, and thanks to Sirius for sponsoring this.

Right. Uh, I think this was a good, uh, good opportunity for us to chat and I'm, I'm, you know, have me back anytime you'll have me. I'm, I'm always happy to be here. Yes. And, and we're, we're gonna do that Drex, I'm going, you know, for the new state show. We'll, . We'll, uh, you have, you have a busy schedule, so we'll, uh, we'll continue to drop you in.

We'll, we'll start with once a month. We'll see, uh, we'll see if we can get it all scheduled. Uh, 'cause I think these are are great conversations and I appreciate. So, uh, that's all for this week. Special thanks to 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.

The show is a production of this week in Health It. For more great content, check out the website this week, health.com, or the YouTube channel. If you wanna support the show, share it with the peer. Uh, if you want to communicate with us, uh, send me an email bill at this week in health it.com. And we'll be back in on Friday with another interview with an industry influencer.

Thanks for listening. That's all.