During a time as challenging as the one in which healthcare finds itself, agile isn’t a buzzword. It’s a means of survival. And as leaders face an onslaught of hurdles — some of which are constantly changing — the COVID-19 pandemic is “shining a light” on those who aren’t willing or able to respond, said James Wellman, CIO at Blanchard Valley Health System. “You can’t hide from this. If you’re not able to adapt, we’re going to see some fallout.”
Wellman is no stranger to adapting, have just joined the organization — and become its first administrative-level CIO — in July of last year. In a recent interview, he talked about the strategy he used to adjust to the role and gain the trust of his team; an approach that paid off when disaster struck a few weeks ago. He also discusses how they’re leveraging tools like Zoom and TEAMS to support the growing remote workforce, and most importantly, how they’re enabling providers to deliver care.
- About Blanchard Valley
- Using a remoted-hosted EHR: “As much as I can push out to the cloud, I’m going to do it.”
- BVHS’ first CIO
- Developing trust early on – “That has been key.”
- Standing up a remote workforce
- Quick Zoom install – “The physicians have all embraced this.”
- Healthcare’s “wartime innovation mindset”
- Collaboration during crisis
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It’s much easier to restore some semblance of communications than it is to rebuild the data center. And so, as much as I can push out to the cloud and get offsite, I’m going to do it.
They had a lot of good processes in place; that was one of the really nice things coming here. So it felt like I was here to polish, rather than to rebuild.
Developing that trust has been key, because if I had spent that time rounding and nobody knew who I was, or I wasn’t walking around, and then I walk into a situation like this, that’s rough. It’s a rough time for people to be meeting me.
The physicians have all embraced this. They’re working really hard. Our utilization numbers are amazing; when I look at the Zoom dashboards, I see everyone using the system and coming up with new ideas and new things to do every single day. It’s been great.
Gamble: I’d like to talk about what your team is doing, and how the strategy has changed. But first, you’ve been at Blanchard Valley since last summer, correct?
Wellman: Yes, I arrived in July.
Gamble: Can you give a little information about the organization — where you’re located and what you have in terms of hospitals, things like that?
Wellman: We’re in Findlay, Ohio, which is in the northwest. We have two hospitals: 150 beds at our primary location, and a 25-bed critical access hospital in Bluffton. We have 3,000 employees. It’s a really nice area; we’ve enjoyed moving here.
Gamble: Is it a fairly rural area? How would you describe it?
Wellman: Findlay is kind of an anomaly. It’s a micropolitan; the population is less than 50,000, but it’s the number one rated city in the U.S. for five years running, and the hope is to make it six. It’s an amazing place to live.
I also wanted to mention that Blanchard joined the Mayo Clinic Care Network in 2019. Less than 45 health systems in the world are part of that, and so we were honored to meet their criteria.
Gamble: It sounds like it was a good landing spot. In terms of EHR, what do you have at this point?
Wellman: We have Millennium at both facilities. We’re not on community connect; we have a version that’s remotely hosted out of Kansas City, and that includes acute and ambulatory. Our nursing homes are using PointClickCare.
Gamble: How does that work in terms of having a remote hosted model?
Wellman: I prefer remote hosting. At my previous organizations, I’ve taken the platform that it’s much easier to restore some semblance of communications than it is to rebuild the data center. And so, as much as I can push out to the cloud and get offsite, I’m going to do it; that way we can stand up situations anywhere. I learned that while watching what Moore Medical Center in Oklahoma, which was devastated by a tornado in 2013. They ended up having to put up a temporary facility. I took those lessons and said, ‘what would we do in that situation?’ and shared it with my team. I’m not in tornado alley anymore, which is a good thing, but disasters happen. So I’ve taken that approach, and I think it has served me well.
Gamble: Have you had experience with this type of remote hosting arrangement?
Wellman: At my previous organization, eClinicalWorks was remote hosted for our ambulatory session. Our acute product was onsite; we were going to move it to remote hosting, which they’re actually doing now.
To me, I don’t see any issues with it at all. It’s as good as local communications. We have a solid infrastructure here for the network in the region and in the area, which makes sense; if you have a monstrous business like Marathon, there’s going to be good, solid communications. We’re also right off I-75, the major thoroughfare right up and down between here and Detroit that goes all the way down to Florida.
Gamble: So you’ve been there around 9 months or so. I’m sure there was a strategic plan in place. How has it been impacted by the pandemic?
Wellman: Interestingly, I’m the first administrative level CIO in the organization. They had a lot of good processes in place; that was one of the really nice things coming here. In fact, they were starting down the Baldrige journey. So it felt like I was here to polish, rather than to rebuild.
The neat thing is the team has responded very well. They’ve been flexible; we’ve been able to stand up our telemedicine program and get it launched and moving in a hurry when all of this happened. The team has been very resilient. We’re building multiple negative pressure rooms on one of our floors in preparation for the surge should that hit us, and IT is definitely involved in that.
We sent hundreds of people home to work remotely. We’re managing the communications and everything that has to be done with a remote workforce; these are things we had been talking about had but never really done. We pulled the trigger on it in two weeks, and it’s been going surprisingly well. That has to do with a very solid team overcoming obstacles quickly.
Gamble: In that span of nine months, it seems like you had a chance to really get to know the organization and get to know the culture — I would think that would be helpful in a time like this.
Wellman: Definitely. Literally, you spend the first six months walking around learning things, meeting people, and attending a lot of different meetings. Because I didn’t have a predecessor at the same level, some of these things were new.
We’ve introduced some new ideas to the organization and they’ve been extremely receptive, and very appreciative. The culture here has been very welcoming; it’s very much a ‘can do’ group of people. We like to say that we’re small, but mighty.
Developing that trust has been key, because if I had spent that time rounding and nobody knew who I was, or I wasn’t walking around, and then I walk into a situation like this, that’s rough. It’s a rough time for people to be meeting me. Being here only nine months, there are a lot of associates in the organization I’m am meeting for the first time, but that’s par for the course. But in general, people have been very, very open.
Gamble: What about telehealth — what are you doing in that area?
Wellman: Before this happened, we were getting set up. We were looking to create more of an urgent treatment component for telehealth; we wanted to launch that first. We were down to two vendors and getting ready to make a decision and hopefully sign a contract and get that launched this fall. We were primarily going to focus on our internal staff who are self-insured, work out the kinks, and then offer it to the public. And then we would start looking at specialists. So we were already heading in that direction. But when this happened, we had not even selected a vendor, and so we tabled that.
We were also working on a few other projects. We had just established a relationship with Zoom, as they’re HIPAA compliant. They had a business associates agreements. We thought it would be an easy transition. We were looking at a few use cases where we could have providers work with each other between our hospitals and maybe increase the acuity level of the critical access hospital. So our timing was extremely fortunate. I was able to reach out to my contact and launch Zoom with them in 48 hours; we put over 100 providers onto the system and starting to reach out to our patients.
We like that platform because it’s so device agnostic to the receiver. They can be on an android phone, an iPhone, a PC, a Mac, or Chromebook — it doesn’t matter, and that makes it a much better process for us to engage them. The physicians have all embraced this. They’re working really hard. Our utilization numbers are amazing; when I look at the Zoom dashboards, I see everyone using the system and coming up with new ideas and new things to do every single day. It’s been great. Actually, we think they’re going to have a tough time pulling this back in after all this settles.
Gamble: Are physicians using it mostly to communicate with each other?
Wellman: No. We’re going direct to patients. We’ve already had hundreds of telemedicine visits in two weeks. We launched it and had our first telemedicine visits that day with a couple of providers who are very tech savvy, and with whom we had already been working on some other interesting projects. They jumped at the chance to do this. And since a lot of things were released, we were still able to do consents. We felt comfortable using Zoom, because they are HIPAA compliant, and so we didn’t feel like it was a knee-jerk reaction. We could have started with FaceTime or other less controlled options, but this works very well. We’re setting it up. We’re doing a vanity URL, so it looks professional. We have virtual waiting rooms set up for patients. You can use an audio or video—obviously each provider makes a clinical determination with what they need to do with that patient.
Having telemedicine in place has also enabled us to bring in a few out-of-state physicians to provide some services. There were some relationships we had been pursuing, and with the suspension from CMS to allow providers from out of state to work with our patients, that allowed us to do a few things as well. So again, it was very easy launch, and it’s been very stable. We haven’t had any issues with Zoom itself or with capacity. That part has been fantastic.
Gamble: You brought up an interesting point that some people aren’t going to want to go back to the way things were, especially since so many consumers are getting a crash course on Zoom. It may be tough to pull back a bit when this is over.
Wellman: People are looking at this and saying to their doctors, ‘I have to drive an hour and a half just to see you for a routing thing. Can we keep doing virtual visits in the future?’ Our answer is, we hope so. We hope we’ll be reimbursed appropriately to maintain this and keep doing it, so that when the next scare hits, we’ll be more prepared. It offers us so many different opportunities, and we think it’s the way of the future. We’ll ultimately build it in with home monitoring. I’m speaking with a lot of very innovative companies who have some unique offerings.
I’ve been fortunate enough to be involved with a group that’s representative of a lot of CIOs across the country. We’ve started talking every week at a predetermined time, and when the topic of telemedicine came up, everyone unanimously said, ‘This is it. We’re not going back.’ We just can’t see anyone saying, ‘Never mind, we can’t do this anymore.’ Obviously, we’ll go for the BAAs and HIPAA compliance. We think it puts us ahead of the game having Zoom. We’re already looking at embedding it into Millennium so that we can create virtual visits in the future.
Gamble: It’s interesting; this has kick-started something that’s been in the works for so long. It’s unfortunate, obviously, but perhaps there is a side benefit with telemedicine being able to move forward, as long as the reimbursement piece is dealt with properly.
Wellman: That’ll be the determining factor. We’ve proven that the technology is here; it’s viable, and people will use it. I hesitate to use this phrase, but we’re seeing a wartime innovation mindset. Everybody’s throwing things out. We’re doing a lot of interesting things. I’m talking to people all over the country who are doing some really innovative things and sharing them. I thought that was really neat.
I was on a call the other night where another CIO said, ‘Hey, we’re white-labeling and sharing all the source code and putting all this out.’ It was a project they were working on, but he decided it was too important not to share with everyone. That’s what I’ve seen. The collaboration has been wonderful in that regard. Hopefully, we’ll keep that going.