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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. All right, sounds good. Today's conversation is with Steve Labon, CTO for Ochsner in, uh, new Orleans out of New Orleans headquarters. Um, Steve, welcome to the show.

No, thank you very much for having me. Well, I, I appreciate you taking the time. I know that you guys are, uh, extremely busy right now and everybody is really busy. Um, so I'm just gonna get, uh, straight to it. Um, actually before we do, give people a little idea of your, uh, organization, it's scale, scope, uh, reach.

Of those things. Sure. Uh, you know, Ochsner, uh, health we're, uh, the largest employer and largest health system in Louisiana. About 26,500 employees, give or take. Um, you know, a little more than, uh, 2,400, uh, you know, uh, physicians and or advanced practitioners. Um, so fairly large health system. Large it shop 650 people or so, maybe not the largest, but fairly good size.

Yeah, give us, give us a little idea. I mean, you guys are starting to surge at this point. I'm looking at all the numbers, all the different states broken down. There's a great model out online I'm using. Uh, and it looks like, you know, New York is, is definitely in, in right in the thick of it. You guys are, uh, you know, are surging right now as well.

Give us a little context of what your system is doing, uh, around preparation and, and serving your community. Yeah, absolutely. Uh, you know, we are definitely surging. I think per capita wise, we're just as, as bad as, as it gets, uh, for, for the, the world right now, which is unfortunate. Um, but, you know, we basically have four different pillars that we're working on as an organization.

Uh, you know, a community pillar, expanding, you know, certain things to help our community during this time. Uh, expanding our ultimate containment strategies. Like what are our containment strategies that we have as an organization to contain, um, the spread of this? How do we expand our testing capabilities?

So, you know, how do you stand out quickly? Because as people start losing, um, jobs in the, in the service sectors, that impacts your patients and that impacts your, your employees. And now all of a sudden, a lot of people might find themselves as a single income family or, uh, the daycares have shut down. So how do they, you know, if they're a single parent, how do they

They get care for their kids. So you've gotta think on that community level and not just on your normal day-to-Day stuff. Uh, you know, with our containment work, we've done a lot of stuff. Obviously, uh, a lot of folks became teleworkers overnight. Uh, as you can see, I am one. I'm I'm here in my home as well.

So how do you support 4,000 Teleworkers? Who? Working in the office and on a Friday they're all working from home. So how do you do that quickly, uh, and seamlessly for them so they can continue to take care of our patients and take care of our organization? Testing's. Interesting. We did a lot on testing.

Um, you know, one of the things we did, uh, we developed our own in-house testing capabilities. So, uh, I don't know if everybody's doing that, but when you're reliant on commercial testing from external places and or the CDC. The turnaround time on that can be several days and they got inundated with that.

So we've done that. Stood up our own testing, uh, been doing that for about two weeks now, um, which is great. So expanded that. And then last on care, lots of new ICU beds, expansion, you know, we stood up my team and, and some others. Um, actually stood up 50 new ICU beds in two days. So that's impressive to put all that equipment in the rooms, get all that up and running.

They're working around the clock, but, uh, I've expanded 84 total beds within a week. Um, you know, so all that's the work that we've been doing. Wow. It, it, it strikes me as you're sharing those things that, uh, the communication within your organization sounds like it's, it's really well thought out and that you guys are communicating really well.

Can you, can you give us, uh, I'm already jumping off the questions that I normally would ask, but can you give us an idea of, of the communication structure that you guys are, are using to make sure that everybody's informed. Yeah, absolutely. And I think that those, that, that aren't getting hit hard yet, you will need to think this through, I think communication, you know, and the, ultimately it's the elimination of confusion that you're after as a leader.

The elimination of confusion is gonna be key as you go through any crisis. And so we've got, um, you know, I. I, I wouldn't say over communication, but we've got a well-structured daily huddle with every director and above from an IT standpoint. So we meet every day in a daily huddle for 30 minutes to go through our day's response.

We move to a seven day a week schedule, um, to make sure that we provide, you know, um, support throughout this crisis. Because Saturdays and Sundays where it. You know, some IT folks had that off. Uh, traditionally when you're in this crisis response, you're gonna need to work throughout the weekends as well.

We have a response center that's set up, so it's sort of like your command center, but we call it a response center to coordinate our response. And then when you talk about that communication, putting in those contexts of those pillars becomes important, um, for your senior leadership. Because if you, your, your individual contributors, you know, they're gonna be working on lots of different things.

You know, we have a list of, of a hundred things that all of a sudden new work, they're getting pulled to. And if you can't eliminate that confusion and show how that aligns into a, a greater plan and that you're moving forward in that greater plan, you're gonna start to suffer from poor morale and you can't have poor morale with a large team.

Um, as you, uh, go through a crisis. You need to work on that as a leader and work on your communication. Yep, absolutely. So, uh, you know, what's, what's one thing you've discovered over the past few weeks that might benefit others? I mean, since you are further along in the surge, you know, what's, what's one thing that sort of stands out that you've learned?

You know, I, I think, um, you're, the scheduling of the team is actually important. It might not be the, the, the most interesting answer, maybe when you go through your interviews, uh, . But scheduling your team's gonna be important because as you go through a real surge, these numbers that you see on tv, um, they're not just numbers.

They're real people. And those numbers are gonna start to impact your caregivers and they're gonna start to impact your IT team. So what is your plan as a leader, as your IT team starts to get sick? Because your field techs, your people that are on site, your asset teams, you know, they cannot not show up to work.

They're healthcare workers first. And as they're on these floors and as they may get, um, ill with, with either the coronavirus or any other virus and they go down, what is your plan? So how do you schedule for that? How do you plan for that? And how do you keep an engaged workforce that's still willing to be on that front line?

So that's, that's an interesting thing for me. I don't know if it's the most interesting answer that you may have hear, heard from others, but, um, that's something we spent a lot of time on, making sure that when people do go down, we have someone to come in. And you gotta keep in mind this is a long term thing.

So if people think this is a one week, two week thing, it isn't going to be, this is gonna be two to three months if you're lucky with this sort of, uh, staffing plan. And it's probably gonna be longer than that. So you gotta really think that through. Yeah, I, I, I, we're gonna have c ovid 19 around for a while.

I, I think the surge, as we're looking at the numbers, surge looks like a two, three month kind of thing. And, and it's getting people into that mindset. I'll tell you why. That's an interesting answer. 'cause it's not one I've heard before and we've done a, a fair number of interviews at this point, but the scheduling is, is, is really interesting to me.

And then, uh, one of the things, and I guess I should have thought about this and maybe if I was in the chair, I would've thought about this. Uh, it's keeping health it people safe. Now we're in the business of, of helping the caregivers stay safe and I've heard people, you know, putting iPads in the room so that caregivers, you know, can actually take care of patients without going in as often and those kind of things.

But I hadn't really thought about keeping the health it workers safe. Are are, is there like training around that or, or are we, how, how is, how is that being done? Well, you know, at Ater, uh, everybody gets trained on their . Station. Um, and when this, uh, crisis broke out, we, uh, sent out and retrained everybody as well.

So everybody's got training on PPE and then every IT staff, you know, we divided our IT staff into two onsite and virtual. Now, uh, we have, you know, onsite, we probably have a hundred or so folks virtual. Five 50. Um, and all the onsite folks have like masks. We make sure they all have a mask, so when they need one and to use proper PPE when they go in the room, our solution is, you know, you gotta keep in mind like, um, you know, we're healthcare workers first and that's what everybody knows and we're not going to impact, uh, negatively impact the care of a patient because somebody is like afraid to go in the room.

We have the right tools, we have the right equipment, . Protect our IT staff, and we're going to do that. However, when people do get ill and when they do get ill, whether from a work exposure or from, you know, a general community exposure, uh, you know, what is your plan on that? Because you might, you know, if one person goes down, that's easy to backfill, but what happens when four people on a six person team are, are ill and out for two weeks or under quarantine for two weeks?

What, what's the leader's plan then? And so from a resource, uh, standpoint, you gotta make sure you're still very effective in your actual ability to solve the, the IT problems of the organization. Yeah, I do. So, um, you know what, what, what's one thing that your team has been able to do that, that we would be most impressed with?

And I sort of coached you ahead of time to say, you know, everybody's talking about telehealth and, and, and expanding work from home. Those are really impressive. So if you want to talk about 'em, I get it because it's, uh, I mean, what we've, what we've done over the last couple weeks are amazing. But I, I'd love to hear, you know, practically, how, how did you pull some of that stuff off?

You know what, believe it or not, a lot of stuff we had already done, you know, a lot of groundwork for, so when, when 4,000 Taylor workers go home one day to work, we already had remote connectivity capabilities, you know, really good infrastructure, really good bandwidth. We, we were, you know, uh, lucky at all those events that we had.

You know, sort of planned and thought about that. Uh, being on the Gulf Coast South, you know, we're, we're always ready for a hurricane, uh, , so, uh, no matter what month it is. And so you're always ready to like, if you have an extended work from home situation. So those were good, but some of the things I think that we did that might be a little bit unique and or maybe people aren't thinking about them right on the top of their, their, their heads is yeah, tell your telehealth, uh, solutions are going to expand.

Um, and they expand, I think, in a different way where before, you know, you develop the solution, you put it out there, you can get by it. The opposite suddenly happened like this. Now we have 26,000 people who are coming up with telehealth solutions and they're hitting us with them saying, how are you gonna solve this problem, this problem, this problem.

One of the, the solutions that I, I thought we did a really good job on was, uh, virtual patient visits. Not for the provider, and that's where most people are gonna go, but for the patient and their family. Because when you go into, you know, a, a crisis situation where there's a pandemic, we're limiting visitors and you have very ill people in hospitals and not everybody you know, is ill with covid 19.

You have terminally ill people sometimes in hospitals. And so what are you doing to enable them to continue to visit with their families? Um, and so we actually, uh, you know, we went low tech with it a little bit. Uh, we went with some old, um, some older tablets that we had with some Skype accounts. Generic Skype accounts, and we bring those to patients so they can at least do virtual virtually, visit with their loved ones.

Because right now we have restricted visitor policy. So you've gotta think that through and plan that out, and come up with a, a solution that's somewhat scalable, um, and it becomes doubly hard because. You know, getting hardware can be, uh, somewhat challenging for that. I, I, myself actually drove around and hit all the Best Buys, shout out to Best Buy, uh, here in the, in the North Shore.

Uh, but I picked up 31 Best Buys over, uh, 31 iPads over, uh, three Best Buys that I hit, that we used for, for some of these use cases. So, uh, you gotta get a little creative, uh, especially as you're spanning these, these, uh, solutions quickly. Yeah, and I heard that from somebody. Uh, I didn't interview the person.

I was talking to him on the phone and they said they, they placed a, a massive order. For stuff and they just went down the list until they found something that was in the inventory and that's what they got. They got a tablet that was available that they could do this stuff with. It's amazing. But you're ACTO, so I I, I'd be remiss if I didn't ask you about scaling.

I mean, we we're scaling at a rate. Normally ACTO would sit back and go, Hey, you know, give me a little time to scale this. Um, I know you put some of the stuff in place, but you still have to, you still have to worry about, uh, latency, bandwidth, uh, capacity within your data center, security and other things.

Uh, talk a little bit about, about scaling this out, how you, how you approach that. Yeah, I mean, you know, we have flexibility already. I think any, any technology leader, C-I-O-C-T-O or otherwise, you know, if you are already at your cap of what you can scale to uh, uh, like on your regular day, you already have work to do.

So if you have a one gig max internet pipe because your routers are limited or, or your wan routes limited, you, that's something you need to solve now, not when you, when you're in the middle of a crisis. So we were lucky that we had that scalability built in. Now we didn't have, you know, we were only using, we have a five gig internet pipe.

I'll probably bore some of your users here when I get, if I start using too technical language, but, um, you know, a five gig internet pipe. Um, but we could scale it to 10 gig, you know, and right now when, when we moved all those folks from home, they only peaked about 40, 50% of our, our preexisting internet bandwidth.

But we were able to easily scale it to seven. So, um, with regards to like our turnaround times, I, I would sort of turn around a little bit on both yourself and your customers. Like you need to be . You need to be the IT team that your organization needs you to be. And right now we need to be fast. That's part of it.

And so not every project management process that we have in place to manage our work, not every normal turnaround time is acceptable anymore. And that was one of the first things we did is with our asset request process, how do we make it fast? How are we making sure we acknowledge that we've received your request within one hour, that yes, we have your request, and how do we still get you that hardware quickly even though it's a lot?

And so you really have to look at your processes and you have to, um, you know, be flexible with, with what you need and why. Um, you know, if you're spending two days to make sure you appropriately charge back a device to the appropriate cost center right now. Um, it's probably not in the best interest of the organization.

You know, I just tell people, charge it to my cost center and we'll figure that out, uh, after we're done. So, so I, I think you do have to move a little quicker than you usually do, and I don't think you can be an IT leader saying, please give me some time. I think you need to look at it and say, how do we move faster?

And that's where like that seven day a week schedule comes into place. That's where buying hardware. Not hoarding it, but making sure you're buying the hardware you know you're gonna need before you know exactly what you're gonna need. Like we know we need these cameras on tops of these, these, uh, , these uh, computers right here.

Um, so if we don't know the number, we know we need at least need a few hundred, buy a few hundred while we're waiting to figure out that number. Alright. You might be two weeks ahead, you know, what's one thing in the prep process that you wish you had either known or done earlier? Um, you know, I think, I think knowing how long it would this would be, I think is, is probably the, um, the most important thing.

I wish I knew because when, you know, patient one comes to your state, and I know, I think, I think every state's passed this point, so this might not be very helpful for folks that might see this, but when patient one comes in. You're thinking the containment strategy is gonna work and this is going to go away.

And so we started planning with a really like a two week, three week sort of plan thinking that was gonna be sufficient and a week and a half into this when you're not no longer patient one, but you're a patient 500, that quickly, that's where we realized that this is going to be a new normal for us.

And so I think that's the big thing I wish I'd known because those first few days, our plans were very temporary, right? They were very temporary, a three week staffing plan, um, as opposed to a three month staffing plan. And so I think that was the one thing that I wish I had a little bit more, um, um, insight into.

But if you look at how, I think frankly, the whole country went, I think that was everybody's idea, was containment was going to hopefully stop this in its tracks. And now I think most people can agree, um, I don't think there's any stopping this in its tracks. This is about, um, ensuring that um, if people get sick, they're getting sick at a rate where the existing system can still continue to care for them.

And that's what containment's really about. And I wish I had that perspective going into it. Yeah, it'll be, I. You know what? Experience is a great teacher. And so we will have, we'll have this experience moving forward. Um, but it, but it's hard, right? I, I talked to, uh, uh, I talked to Dale Sanders and he, he was giving me military analogies and he said, you know, you don't wanna scramble your fighters for every, for every crow that flies by, that gets picked up by your radar.

And, you know, so we're gonna have this experience and the hard thing's gonna be for us to not kick into, you know, full-blown battle mode when it's, you know, it's, it's something that's really small and manageable because we have this experience, but on the flip side, we'll have this experience. So we won't take these kinds of warnings lightly, I guess is, is the way to look at it.

Absolutely. And as, as an next person for the military, I can appreciate the analogies, you know, and keep your team combat effective and, uh, make sure you're well resourced and your logistics and your information's flowing, you know, and, uh, all that information keeps your morale high. And with a, with a fully engaged team, there's no like, limit to what they can accomplish.

So keep 'em engaged, keeping the leader they need to be. Absolutely. Steve, thanks for your time. I really appreciate it. No problem. 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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