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

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

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

They reached out to me to see how we might partner during this time, and that's how we've been able to support producing daily shows. Special thanks to Sirius for supporting the show's efforts during the crisis now onto today's show. All right. This morning we're joined by Chad Ine, CIO, for St. Luke's University Health Network.

Good morning, Chad, and welcome back to the show. Good morning, bill. Thanks for having me. Uh, it's always, it's always good to catch up with you as, uh, I've alluded to before, the, uh, St. Luke's is where my parents actually, uh, go, uh, for their healthcare and, uh.

Um, but his experience was great. I appreciate all the work that you guys are doing. The digital experience was great that the medical record has moved back and forth between, uh, California hospitals and, uh, a bunch of epic hospitals. So you guys have done a lot of great work with regard to the EHR and digital and, and other things, so I really appreciate that.

Well, thank you Bill, and I appreciate you, uh, dropping me a note and letting me know about his experience. I sent that to our president of our Anderson facility and he was grateful. For you doing that? Well, yeah. So here's, here's what I'd love to talk about. So my parents, you know, we, we had the conversation of what their experience was like, uh, you know, during covid and, uh, uh, it's, it's interesting how, you know, people are experiencing this.

And what I wanna start talking about with health leaders like yourself is, what's it ourselves.

But this is how a podcast goes, by the way, the, the lawnmower comes right by the window, right when we start the podcast, . Um, but I probably have a plane land in the backyard over here, I'm sure , but yeah. Not to get too far ahead of ourselves, but I, I do wanna start to explore what this is gonna look like, uh, as we come outta the pandemic, uh, before we experienced you.

Sure. Um, so as you know, bill, we're in the, uh, eastern PA side. So we're very close to Jersey. We actually have one facility in Jersey. Uh, and as you know, Jer Jersey, New Jersey and, uh, New York. New York obviously the hardest hit of the country. Uh, so we have a lot of traffic come up to one of our hospitals in the Poconos, uh, because it's a, um, resort area for the folks in New York City.

So they travel there a lot. So we got hit harder there earlier. 'cause we have a lot of back and forth, New York City traffic. So one of our campuses, the Monroe campus, uh, saw the earlier signs of the patients and really their volumes peaked out, uh, pretty high for us at that one campus. And then we began seeing it kind of migrate down.

Um, as you know, my role is beyond it. I also have supply chain, uh, radiology and some other departments. So my primary task for the organization was to set up a virtual command center. So that was literally like. Early, early March that we began doing that. And then my second focus was around PPE with the supply chain focus.

And one of the things we had was a lot of limitations around our systems. So, uh, we really needed to do a couple things. One is figure out our search capacity plan, figure out our PPE, uh, capability, and then make sure that we're managing our labor, uh, through that process. And so those were kind of the roles.

And we reacted very quickly. Were able to set up a lot of, uh, we ended up building actually a lot of custom technology with some of our, uh, power apps and low-code technology and stuff like that to augment what we had, uh, around all that. So it was a really nice setup, but we really saw, you know, kind of a peak.

We put a bunch of different, our, uh, strategy department put a bunch of different models together. We're very fortunate that none of those models end up hitting where they were at. We picked out at about 300. Inpatient covid, uh, patients per day. Uh, and now we're down to around a hundred. Um, and you know, we, we saw testing go from five to six days at the beginning of this to now, you know, less than half a day.

And, and most of our testing is within a few hours. Um, one of the other things we saw around Covid was, uh, we've seen some other organizations have higher, uh, infection rates among their employees. Ours is less. It's a combination of our, uh, PPE guidelines that we were able to have, and we were able to have the appropriate amount of PPE because I think we were able to, um, source unknown suppliers very quickly, uh, that were external, you know, not within our GPO, uh, to be able to get alternative products.

So, uh, that's probably more than you wanted to know, but. Um, if you have any additional questions, I'm more than glad to, to spend some more time on that, but obviously very unique situation and, um, you know, you know, it's, it's, you have such a unique perspective because you do have, um, you know, you do have supply chain and you do have some service lines, which is kind of, uh, uh, interesting.

And we've, we've talked about that before on the.

Configure things and put apps out there very rapidly so people can go back and listen to some of those shows. We've talked about those before. Um, but I, I wanna really explore the, the it side a little bit. So, you know, we, we saw huge gains in telehealth. We did a lot of stuff to conserve PPE by using video and whatnot, you know, as you can.

Those will be integrated in our, uh, post pandemic work models. Yeah, so just a little bit around our virtual care. So, um, you know, we, you probably saw the, the Microsoft Teams video with St. Luke's University Health Network in it, uh, that was played nationally. Uh, and as you know, we've had a Microsoft partnership for a couple years, strategic partnership with them.

Uh, and we had done a lot of the foundational work activities around the platform. Prior to this as redefining our entire communications infrastructure within St. Luke's. Kind of think of it as the EMR, uh, but redefining communications in a platform, uh, like thought process. So, uh, what we really saw is an increase, obviously, in virtual care.

So our, our primary care physicians and our specialists began leveraging that. What was very unique is the phone calls. We're at the beginning of it, the number one used virtual platform, right? And then what we begin seeing is it increasing to Microsoft teams. And um, you know, we did in our first month a a hundred thousand virtual care visits.

So, um, which is, you know, we are basically doing 75% of what we normally see in a practice virtually. Uh, which was amazing. And, um, I can answer questions. There's obviously a lot of hurdles around that, that we, uh, experienced, um, but, uh, pretty, pretty amazing, uh, to see our organization flip that quickly. So do you think, uh, you know, we, we talk a little bit prior to this.

CMS has sort of stated that we believe this is the future and we're gonna continue to fund it as such, and typically the commercial payers follow. So if that's the case, are you guys, are you guys all in at really transforming from maybe a physical to a, to a virtual for, for a bunch of this stuff? I mean, I think the payment model is gonna be the, the key thing for us if, if payers will pay, we'll be all in.

If they don't pay, I think we're still gonna have to be in the question just, is it all in or not? I. And, and I think that that's where I kind of, uh, go back and forth between all inner or halfway in, if you wanna call it this. This is why I love talking to you. You have business line experience, so you're, you, you think and talk like a, like a, like ACIO should in terms of really understanding the business aspects of it.

Um, you know, how have you experienced work from home at this point?

Uh, from what I'm hearing, we haven't really had that. So, uh, how have you guys experienced it and, and what are some of the things you guys did? Yeah, I mean, we definitely, obviously, um, I'm sure like most organizations have supported a virtual, uh, capability. I mean, with the, the technology that we're using today and other technology similar to it, we're, we're obviously the Microsoft shop.

We've been able to really improve communication and collaboration. It's, we used to, uh, and you used, you know, you've spent some time with me at St. Luke's. Uh, we would always call it the St. Luke's five, and that basically meant we were always five minutes late to the meeting. Well, that was because we were having to physically go every place.

Well, I've been on so many on time meetings in the company's history. It's just amazing to see. So I know that I'm getting better at, I get better at that. And then I've really seen a reduction in the time in which people wanna spend on a meeting, like 15 minutes, a lot more, 15 minute meetings and stuff like that.

Just a quick pop in or a check in. So I've really seen the communication change. Um. I'm also, uh, working on a project with Microsoft right now. Uh, there's a product called Workplace Analytics that we're running right now to look at the pre covid, how we work, uh, from a communication and collaboration perspective to post Covid.

Uh, so I hope maybe I can come back and share some of those results with you, uh, because we'll have all the data from teams outlook. Tasking project, all of it to kind of look and see how our work transformed during this. I'm very interested to see how that's, how that's changed. Yeah. Love to do that. Uh, so today is, is May 22nd.

I'm gonna put the date in here, even though, we'll, we'll air it a couple days later. Um, but the reason I'm doing that is 'cause I wanna talk about what your priorities are today. And I, I.

Your priorities are right now and what they'll be post pandemic? Yeah, I mean, we're just coming off of rolling down our command center. Um, our virtual command center and also, uh, really pulled back on, uh, where we've got a nice healthy supply of PPE. So we've kind of, what I would consider, you know, stabilized the pandemic, if you will.

And we see the numbers coming down for us, and that's just as of recent. So now obviously I'm getting a lot of the requests like, where's my project? Or where's this or where, where's that back again? So that's, that started to ramp up. So I. We're gonna be going back through all of our projects and we're really looking at what we keep versus not.

But whenever I think about what we're gonna be doing over the next six to 12 months, if the, if. Well, with or without payment, we're gonna continue to optimize virtual care. Depending on how much the payment transitions, I think will depend on the size of investment that we decide to put in it. So, you know, we'll be putting a business case around virtual care, uh, looking at all the scenarios and really the determining how that's gonna change.

But we do know, I mean. We've already been doing, we, we always are doing cost reduction strategies within healthcare. I think there's, you know, a pandemic, highlights the need to do that even more. So we'll continue looking at labor efficiencies and ways to be more efficient at delivering care. Um, and I think that this is obviously put an additional lens on, uh, that perspective.

And then we'll, we'll obviously continue. We've been, uh, and you've helped me do some work around this. Continue investing in our digital front door. Uh, that work is never done. Uh, and we'll continue to try to make that as efficient and as high. You know, my goal with the self-service is until we get to a hundred percent self-service rate on every one of our transactions, we're not done.

I, I'll probably unfortunately pass away before I ever see that happening, but. I, I'm gonna keep, you know, the energy and the focus on making all of our transactions as easy as possible for our consumers and making sure that, you know, until every single one of them, uh, does it and does it in an efficient, easy manner for them.

You know, we're not done with that work. So that's, that's probably the four or five buckets of, of categories that we have going on, uh, within St. Luke's. Wow. Oh, well you have a lot going on. The, you know, we're starting to see signs of life where we're seeing the claims data grow Monday. Uh, the Monday claims data is growing in volume across the country, and even, even, uh, in the northeast is starting to grow.

Uh, what kind of things is your health system doing to expand those, those procedures at your health system at this point? Either from a safety standpoint or from a, you know, getting the, the revenue stream back. Yeah. So. We began elective surgeries. What? It's the 20 seconds, I guess. Two weeks, two full weeks.

Uh, and we're probably back upwards of around 85% of our revenue back, uh, through the month of May, where we saw it dip. Obviously we, we, we took a couple of brittle months, I'm sure like many other organizations, but we've seen it start to pick back up. So I'm very hopeful, um, that we get stuff back up in June.

Like in June, we see a nice full month. Um, of, of healthy volumes. Um, you know what's interesting is there's a backlog. I mean, you know, people, people don't just stop getting sick. They, they, they tend to avoid things. And so then the question is really what's, what, what impacted people's health by not taking care of the things that they have and how, how has that impacted them with or without the benefits coverage?

So I think what's gonna be interesting to follow is, you know, this unemployment rate at whatever, it's 40 million people. What benefits have that impacted people, and then how does that compare to their need to get their help done? It's gonna be very interesting, but I, I see our surgeries backed up. I mean, man, we were already on a backlog.

Think about how big the backlog is now. So, um, that's, there's gonna be a lot of volume. I think that we have, um, a pent up demand. I, I guess is what I'll call it. Yeah. So h how, how are you planning from a, a health IT standpoint to plan for a second surge? I, you know, there's, there's a lot of talk about this.

Uh, you know, in the fall we might see another surge as we start to open up. And, and most pandemics actually do have multiple, uh, multiple spikes or, or you guys, uh, talking about that, planning for that. Yeah. So I guess I'll answer it from my role perspective. What, uh, so to. Primary front and center, even though I'm the CIO is, is making sure that we have appropriate PPE.

Supplies. So making sure that we have a healthy, healthy log of all that. So that's my primary focus. My secondary focus is making sure that we get the physician's feedback, which we've already done, and begin enhancing our virtual care process. Uh, so we are already on the path to do so. Those are probably my top two things that I see really, that needs to, uh, occur for the second wave of this.

Yeah. So what's your, what's your greatest learning so far? Um. You know what I really. We, we, we implemented a, a kind of a, um, and you're probably familiar with a development world, but kind of a squad mentality for solutioning. And we put like pods of people on different types of things. And one of the things that I really wanted to do, uh, before this was give my other teams the ability to do low code and other types of projects like the Epic analysts and stuff like that.

Teach them how to do . Not necessarily build code. Maybe eventually, hopefully, but get more skilled up into other platforms. And that's probably the one thing that I think that I've really enjoyed watching my team do, is be willing to pick up all these additional skills and just jump in. And I think coming out of this, they're gonna have, you know, multiple, if you want to call it technologies on their belt.

Uh, and that's really, really gonna help them. So that's the, that's the positive thing that I think at least the IT team have. Really picked up on through this . Well, Chad, I, yeah. I'm sort of laughing because you know, I appreciate you the time, but I think I went over so you're minutes late meeting That's.

Always good to catch up. Thanks. Yeah. Hey, thanks Bill. That's all for this week. Special thanks to our sponsors, VMware Starbridge Advisors, Galen Healthcare Health lyrics, Sirius Healthcare and Pro Talent Advisors for choosing to invest in developing the next generation of health leaders. If you wanna support the fastest growing podcast in the health IT space, most of you can see this now.

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