“Grit and Grind”: How a Solid Infrastructure and IT Team Have Become Difference Makers

To say that the Covid-19 pandemic has transformed healthcare is an understatement. From care delivery to workforce management, the landscape looks completely different than it did just a few months ago.

And in some ways, that’s not a bad thing, said Nick Fuchs, Enterprise Architect and Senior Director of IT Infrastructure, Service Delivery and Security with Springfield Clinic. “It has really pushed us forward in terms of getting remote policies and telemedicine in place, and advancing our work-from-home culture.”

It has also “really shined a light on the value of technology,” and demonstrated the willingness of IT teams to rise to numerous challenges, he noted. During a recent webinar, Fuchs — along with co-panelists Tilden Conatser, Senior Infrastructure Architect at Optum, and Cheryl Rodenfels, CTO of Americas Healthcare with Nutanix — shared insights on how leaders can ensure the right infrastructure is in place to support the demands brought on by Covid-19.

At Springfield Clinic, which serves patients throughout central Illinois, one of those demands was to continue to provide care despite an 85 to 95 percent drop in clinic visits.

That, said Fuchs, is where virtual care comes into play. The problem? Like many organizations, Springfield hadn’t gone beyond the planning phase when it came to telemedicine, and as a result, was forced to act quickly — and creatively. “We were able to stand up a telehealth platform essentially from scratch, using a multitude of technologies. It really was a tremendous uplift. We met the demands of the business, and the organization was really appreciative of the effort.”

At the same time, Springfield had to address another need: setting up telecommuting capabilities for about 600 workers. “The conversation was, we need a solution now,” he recalled. “It has to be operational, and we have to have everyone on board in 2 to 3 weeks,” despite the fact that this type of initiative normally takes 6 to 12 months. “We banded together as a team, we put in crazy hours, and we got it done.”

It’s an impressive feat, and one that Fuchs believes wouldn’t have happened without the right infrastructure in place. Fortunately, prior to the Covid-19 outbreak, Springfield had been working with Nutanix to rebuild its virtual and end-user computing environment to support the EHR migration.

“The way we built the infrastructure, it was scalable enough and flexible enough to support an influx of remote workers,” he said.

Of course, there are numerous other roadblocks organizations have run into. Below are some of the examples discussed by the panelists:

• Understand workflows. “It’s so important to understand your workflows and what the requirements are,” said Fuchs, which, of course, vary from one organization to the next. Some might install Microsoft Teams software over a VPN, while others might do it from a home workstation.
• Dealing with devices. For many organizations, those outside of IT and administrative roles may not have laptops. As a result, they have to share with family members, and for the most part, are using devices with bandwidth that’s more appropriate for streaming Netflix than for performing key work functions. “A lot of organizations have had to figure out, what can we do quickly? What devices can we get into their hands while we maintain our security and make it easy for them?” said Rodenfels.
• Desktop-as-a-Service. And even for those who do have laptops, remote access doesn’t always offer the same views and functionality, which can be frustrating, particularly for non-IT staff, she noted. One tool that can help is Xi Frame, a cloud-based offering that can “spin up a desktop as a web service,” eliminating the need for a new physical computer, she noted. “It’s about getting creative. Can you work with office products that are online? Can you do a web version? It’s also getting quick access to PCs and monitors people can take home. You have to quickly figure out what are your requirements in terms of bandwidth and access, and package it up and get it out there.”
• Prioritization. During a pandemic, prioritizing access isn’t just smart; it’s necessary. According to Rodenfels, Nutanix’s environment enables users to identify the most critical applications, based on workloads, and expand their capabilities. It lets users “manage and monitor whether you need more or less storage or computing,” she noted, which is more critical than ever before. “You have to have that flexibility to meet those needs, and do it fast.”
• Vendor partnerships. For Fuchs, one of the biggest surprises during the past few months has been support from technology providers, whether it’s increasing bandwidth or giving out more licenses. “It’s been really eye-opening,” he said, and it further drives the need to build “deeper partnerships with vendors.”

Unfortunately, some vendors have viewed Covid-19 as an opportunity to build their customer base by rebranding solutions. “There’s a lack of awareness and sensitivity with what IT organizations are going through,” noted Fuchs. “If you’re facing furloughs or cuts, the last thing you want is for your inbox to be flooded with requests.” He urged vendor leaders to act with awareness, and to use it as an opportunity “to grow relationships and build stronger partnerships through genuine support.” Organizations like Nutanix, Microsoft and Avaya — to name a few — have done just that, Fuchs added.

Finally, it’s important to remember that what’s been done from a telemedicine perspective — where organizations had it up and running in a fraction of the usual time required — is not a repeatable model. It’s an extremely complex process that was compressed out of necessity (and was helped along by the relaxation of HIPAA rules), noted Fuchs. From tracking and recording visits in a centralized location, to coordinating with the business side, to navigating the reimbursement piece, there’s a lot that has to be navigated.

“How do you do this quick enough to support an 85-95 percent drop in patient visits, and continue seeing and treating those patients and providing that care? It takes a team,” he said. “It takes communication. It takes collaboration. It takes grit and grind. It’s coming together to understand the challenge, define what needs to be done, and execute.”

Rodenfels agreed, adding that as organizations return to “some sort of regular cadence,” the ability to create a surge capacity will be vital. “You have to balance these things as your organization figures out what is the right mix and how to accommodate all of it and afford it.”

To view the archive of this webinar — Ensuring Your Infrastructure Can Support a Remote Workforce, Telemedicine & Dramatically Increased Patient Load (Sponsored by Nutanix) — please click here.