If B.J. Moore could offer one piece of advice for fellow healthcare IT leaders, it’s this: “You always have to be preparing for a crisis. You can’t wait until you’re in the middle of it to respond.” And as organizations deal with the ramifications of the Covid-19 pandemic, whether they’re still in the thick of it, or have started to move forward, his words hold true now more than ever.
Recently, Moore spoke with healthsystemCIO about his team’s response to the outbreak, which has been complex given the diversity of the areas covered by Providence St. Joseph, from Washington (the first Covid-19 hotspot) to rural Montana. In the interview, he discussed the value of simplifying IT systems; the unexpected benefits and challenges his team experienced; and the strategy they’ve adopted in moving forward.
- A years’ worth of work in 6-8 months
- “How do we maintain the momentum?”
- Acting on a system level
- PSJH’s simplification strategy: “It has paid dividends.”
- Growing the remote workforce exponentially
- Unexpected challenges with payroll
- Changes in design systems & processes going forward – “We need to make sure they aren’t bound to an office setting
- Rise in telehealth: “The hard part was in getting people over the change curve.”
If I were to offer advice to other CIOs, I would say that you always have to be preparing for a crisis. You always have to be preparing for resiliency. You can’t wait until you’re in the middle of it to respond.
When we design systems and processes in the future, we need to make sure they aren’t bound to an office setting. The entire concept on being bound to an office setting may be a legacy.
It’s making sure we have a cybersecurity strategy that allows staff to work where they want, and making sure those devices are securely connected to our corporate network through the VPN. How do we manage these systems remotely? Do we have tools and processes that can function remotely?
Change can be hard. Patients have gone into an office to see the doctor throughout their lives, and maybe haven’t been interested in doing a teleconsult. But now it’s the only option; people have to been forced to try it, and for a lot of them, it’s turned out really well.
Gamble: In terms of IT, what have been the key areas of focus in response to Covid-19?
Moore: A couple things. One is, how do we maintain the amazing progress we’ve made during this crisis? In the last six to eight weeks, we’ve done at least a year’s worth of work, whether it’s office deployment, network upgrades, telehealth deployment, telehealth adoption, or Teams adoption across the board. We’re focused on how we can maintain the momentum we’ve built through this crisis in supporting our caregivers, supporting our ministries, and navigating shifts in business models.
Those are the positives. On a more tempered note is the fiscal responsibility that healthcare systems face. How we begin to tap the brakes on some programs? What can we defer or cancel? What are some cost saving measures we can adopt as we look ahead? It’s about maintaining the technology momentum we’ve built, and then deciding how to tighten our belts and find efficiencies during these tough financial times.
Gamble: Being a health system that covers such a large geographic area, I can imagine you ran into challenges some states hit harder and earlier by Covid-19. How did you approach that?
Moore: In Washington, we had the first patient to be treated for Covid-19 in the U.S., and so we had to ramp things up quickly. We knew this was going to spread to our other states, and so everything we did was at a system level. We try to always act as a unified health system. And so, although we had to scramble to catch up in Washington, in our other states, we were able to be proactive and put tool in place for our ministries and caregivers prior to the surge in patients. It wasn’t reacting to states individually, but rather, doing things on a scalable level.
Gamble: What have been some of the key lessons learned?
Moore: One thing that’s been really nice is that our three pillars of strategic focus were already aligned. We working on this before others knew what Covid-19 was. And so, if I were to offer advice to other CIOs, I would say that you always have to be preparing for a crisis. You always have to be preparing for resiliency. You can’t wait until you’re in the middle of it to respond. There are things that we, as CIOs, have to do in advance: simplifying our environment, modernizing it, and working on innovative areas like machine learning and big data. We were proactively doing that when the crisis hit, and that really paid off for us.
Gamble: When we spoke last year, you talked about the work that had been to improve the infrastructure. I’m sure that has proven critical.
Moore: Absolutely. When I joined this organization about 16 months ago, one of the first priorities was to simplify the environment. There were four video and voice communication platforms being used: WebEx, Skype, Leach, and Teams, which just isn’t manageable. And so we immediately chose Teams as our single platform, and retired the others. By the time Covid-19 hit, I’d say 90 percent of us were already on Teams.
At the time, that simplification strategy probably seemed pretty tactical. But when the pandemic happened, we were so glad that we were already on Teams and could work remotely, particularly our caregivers. That’s just one example of how that infrastructure investment has paid dividends.
Gamble: So you already had a remote work policy in place prior to Covid-19?
Moore: We did. Our workforce is spread over seven states. As we’ve grown through acquisitions as a health system, we’ve found that a lot of the shared services resources were already working in collaboration. I would say about 15 percent of our workforce was used to working remotely, whereas the rest hadn’t done so. And so, having that core infrastructure in place, and having some muscle built for remote work helped.
But there was a lot we needed to do; there are entire processes and functions we had to enable, everything from the VPN infrastructure to the networking infrastructure to properly configuring laptops or getting laptops into the hands of our caregivers, and helping them through working from home for the first time. And that was a big lift, considering that the amount of people working remotely is around five times what it had been.
Gamble: How will all of this change your strategy going forward when it comes to enabling remote work?
Moore: It has already changed our policies on things like laptops versus desktops. The computing power of a laptop is enough for pretty much all of our workers, which means we’re not buying desktops anymore. It’s making sure we have a cybersecurity strategy that allows staff to work where they want, whether it’s a coffee shop (although that’s not happening now) or their home, and making sure those devices are securely connected to our corporate network through the VPN. How do we manage these systems remotely? Do we have tools and processes that can function remotely?
A great example is payroll. Payroll had never been done remotely; it’s always been run from the office. With the lockdown, this was the first time we’ve had to run payroll from home, and honestly, the process, the tools, the systems and the infrastructure weren’t designed for that.
Now we know that when we design systems and processes in the future, we need to make sure they aren’t bound to an office setting. The entire concept on being bound to an office setting may be a legacy. It’s something we’ve talked about for years, and now it’s become a reality, and that definitely changes the way we’ll design and secure things going forward.
Gamble: Were you surprised by the reaction both caregivers and patients have had to telemedicine?
Moore: It has exceeded expectations. Obviously there have been some growing pains, but that’s the value of doing this during a crisis; people have accepted some of the growing pains and focused on the benefits. That’s why we were able to do a years’ worth of work in such a short time. We stumbled and tripped and had some mistakes that at any other time would have been unacceptable.
Gamble: From a personal standpoint, I’ve wanted to see telehealth become a reality for a while, so I think it’s great.
Moore: It is, but change can be hard. Patients have gone into an office to see the doctor throughout their lives, and maybe haven’t been interested in doing a teleconsult. But now it’s the only option; people have to been forced to try it, and for a lot of them, it’s turned out really well. It’s efficient; it’s a time saver and you can still get all your needs met. We’re talking about 15 minutes versus two hours in some cases, so it really is a win-win.
The hard part was in getting people over the change curve. Now they look forward to doing teleconsults. Of course, there were relaxations with payments, so it’ll be interesting to see what happens going forward. The U.S. health system can really evolve if some of those regulations stick.