“We’ve Had to Pivot Quickly”: How Cloud Can Help Organizations Respond to a Crisis

As the healthcare industry navigates through unprecedented waters, a number of common themes have emerged, one of which is the need to share best practices. Between the influx of patients requiring care, and the rapidly changing nature of the situation, we’ve officially entered “phone-a-friend” mode, said Imprivata CTO Wes Wright. “We’re all in the same boat, and we’re all trying to help get each other through this.”

In a recent webinar, Wright spoke along with John Kravitz, CIO at Geisinger Health System, and Aaron Miri, CIO, at Dell Medical School and UT Health Austin, about the actions they’re taking in response to the COVID-19 pandemic — specifically relating to cloud computing, and how leaders can effectively guide their teams during a crisis.

At UT Health Austin, the focus has been on leveraging every possible tool to “empower clinicians, whether it’s through dashboards, data sources, or innovation,” said Miri. “We’ve had to pivot the organization quickly to make sure we know what the challenges on the frontlines are.” For example, the IT team set up a drive-through testing site over the course of a weekend, and is leveraging machine learning and augmented intelligence to more effectively track patients with suspected cases. They’re also utilizing 3D printing to custom-make masks for clinicians, as is Geisinger.

For both organizations, supporting the dramatic spike in remote workers and the use of telehealth services has been challenging. According to Kravitz, video visits have increased by 500 percent throughout the central Pennsylvania-based system, while inside the four walls, beds and equipment have been commodities. To that end, Geisinger is using analytics to “determine where we are with ICU beds and ventilators, and when our peak period will be,” he noted.

These decisions, of course, are not made in a vacuum, added Miri, who is constantly in communication with the command team, which includes the CEO, COO and chief clinical officer, among others. That way, he’s able to do a quick ‘sanity-check’ before pushing the go button. Because in situations like this one, “You don’t have time to go through governance. You have to be able to make things happen quickly.” And that means finding out what clinicians need, baking it into the system, and turning it on. “Because if you wait, it’s going to cost lives.”

A Case for the Cloud

For healthcare organizations, time really is of the essence. This, according to Wright, is where cloud can have an enormous impact. In fact, it already has, as evidenced by the staggering growth of Microsoft Teams (which has reportedly seen an 800 percent spike in recent weeks). “If there wasn’t a cloud capability out there, you couldn’t scale up to take on that kind of usage.”

Similarly, albeit on a smaller scale, Imprivata’s ConfirmID, a multifactor authentication platform for remote access, has experienced a 70 percent jump to meet the needs of an expanding pool of telecommuters. Because ConfirmID resides in the cloud, it simply had to be scaled up.

“The cloud has fundamentally allowed us to do what we’re doing right now,” noted Wright. If it didn’t exist, “we couldn’t have scaled up and supported things like telemedicine and remote workers the way we are right now.”

Of course, cloud technology isn’t a panacea for all storage issues — particularly in healthcare, where certain types of files are simply too large. But in many cases, it can be a difference maker, said Miri, who cited several examples of how being “cloud-first” has helped UT Austin more effectively manage the challenges of COVID-19.

• The website runs on Amazon (both internet and intranet), which has allowed them to be extremely agile with communications, and keep people updated throughout the outbreak on everything from screening locations to treatment information.
• With Microsoft’s Azure, UT Health Austin is able to securely scan individuals’ faces to 3D printers to make masks.
• Through its partnership with Google, the organization is able to communicate effectively with at-risk patients.

“We try to go to the cloud as much as possible,” he said. As a result, “We’ve been able to be very agile with our COVID-19 response.”

It’s a strategy Geisinger is working toward, according to Kravitz — but one that must be a deliberate approach, particularly with an organization of its scope, which happens to have three data centers. The goal is to eventually get down to one, then explore hybrid options for the large images that need to be accessible.

“We’re moving more and more to the cloud,” said Kravitz, adding that about 30 of apps now reside in the cloud, including Office 365, which enables workers to easily access email and shared folders remotely. And although moving to the cloud certainly comes with a cost, he believes the availability it offers during times like these makes it worthwhile.

Leading through Crisis

Although having a solid infrastructure in place — and the capability to scale up — is vital while dealing with a crisis, what’s just as critical is providing strong leadership.

During the discussion, the panelists offered the following pieces of advice:

• Lean on others. Kravitz, who began his term as CHIME Board Chair in January, urged attendees to turn to professional organizations for guidance; especially those who are new the role, and/or lack experience with situations of this magnitude. By connecting with peers, whether through group messages, emails, or phone calls, they’ll benefit from the experience of others, and learn how to “be more flexible and agile going forward,” he said.
• Go with your gut. In addition to listening to others, leaders need to listen to their own instincts as well, noted Wright. “This is where experience comes in.” Most of the time, “you know what to do next. Sometimes you don’t have time to check and double-check — you just have to go with your gut.”
• Over-communicate. During any challenging time, it’s incumbent on leaders to over-communicate,” said Miri. “There’s a level of anxiety running through your departments and your teams, especially IT — even if they’re not vocalizing it, and even if it doesn’t make its way up to the office of the CIO. It’s on you to talk to your team.” One way he’s doing that is through town hall meetings, during which infectious disease chairs and chief clinicians are on hand to answer questions. “When facts are presented, people can make smart decisions.”
• Take care of your team. Individuals who aren’t accustomed to working remotely are likely to feel a sense of solitude, said Wright. “The more you can communicate with those people and get those water cooler conversations going” — through channels like Slack, which his team uses — the better off they are. It lets them know they’re not alone.”

Finally, leaders should make every effort to ensure IT feels connected to the larger mission of the organization. One way to do that is by pulling individuals or teams away from their usual tasks and involving them in projects like 3D face mask printing or building dashboards, noted Miri. Another is to provide weekly or even daily summaries of everything IT is working on, and sharing any positive comments from clinicians in public forums. “That’s how you get your team to buy in.”

To view the archive of this webinar — Covid-19 & The Cloud: How Life Off-Prem is Helping Health Systems Fight the Pandemic (Produced in Collaboration with CHIME and Sponsored by Imprivata) — click here.