“The Path Was Already Paved”: How HMH Moved Quickly to Respond to Covid-19

When faced with a disaster scenario, leaders need to do three things — assess the situation, identify the most pressing needs, and develop a strategy — and do them quickly. There’s no time for second guessing, especially when the disaster is a viral outbreak the likes of which healthcare has never experienced, and your organization is located in a hotspot.

Few areas were as “hot” as the New York-New Jersey region. As of May 31, New York City had reported 205,555 Covid-19 cases (including more than 21,000 deaths), while New Jersey had 160,445 known cases, with nearly 12,000 fatalities, according to CDC data. With 17 hospitals spread out across the northern and central parts of the state, Hackensack Meridian Health (HMH) found itself right in the epicenter of the pandemic. And as its many facilities rushed to ensure they were ready to treat the growing number of cases, IT was there to offer support, said David Reis in a recent interview.

It just happened to be a different type of support than in the past, particularly as telehealth became the preferred method of care, the remote workforce grew exponentially, and e-prescribing was enabled for controlled substances.

“We completely revolutionized the way we provide care,” noted Reis, who has been with the organization since 2017. As a result, “we’re really showing how technology can benefit caregivers and patients.”

And although things seemed to happen quickly — for example, it took just two weeks to roll out e-visits in the ambulatory space — building a solid infrastructure has long been a priority at HMH. In fact, having the right foundation in place has been a key factor in the organization’s rapid response, along with the fact that they were already headed down a digital path, according to Reis.

“We really haven’t had to change our priorities,” he noted, adding that the 2020 roadmap included several digital components, such as standing up remote call centers and “having a robust, anywhere-anytime, on-demand infrastructure for our team members. All of these were in the works, and we were able to pull them forward and activate them quickly.”

Some of the key areas of focus for Reis and his team included the following:

• Availability and Accessibility. In some ways, leading through a crisis isn’t vastly different — particularly when it comes to the primary objectives. “There are two main things. One is setting a clear direction, and making sure everybody knows where we’re going, why we’re going there, what’s the timeline to get there,” said Reis. The second is creating an environment where people feel comfortable expressing concerns. “Maintaining those lines of communication and being available and accessible to the people you work with is key.”
• Getting visual. During a crisis — particularly one in which physical distancing is required — the ability to work remotely is a must. With that in mind, HMH deployed Microsoft Teams to enable calls and messaging among staff, and utilized a separate platform for video conferencing and other events. But it’s not just about the technical piece, noted Reis, who believes the visual component can “help build up that esprit de corps that might otherwise be lost in a virtual setting.” And so, whether than means checking in more often, or acknowledging the challenges related to the new social norms, leadership has focused heavily on “making sure people don’t feel isolated.”
• Building on existing capabilities. One of the keys in being able to implement virtual visits so quickly was to leverage existing tools, and fill in the gaps as needed. For HMH, having Epic in place meant that instead of starting from scratch, the team only needed to purchase a bolt-on solution from Vidyo to enable e-visit telehealth. “The path was already paved, but now we’re able to do it at scale,” he noted. “We didn’t reinvent the wheel, which I think is critically important.”
• Collaborating whenever and wherever possible. When organizations are looking to do a lot in a short amount of time, partnerships are extremely important, whether you’re talking about vendors or providers. “We found partners in Epic and Vidyo that helped us meet our needs and get up and running safety and quickly,” Reis said. On the provider side, IT collaborated with the physician division to get users trained on the system. “It’s the perfect example of what happens when you have the right people and the right tool at the right time,” he noted. “Necessity is the mother of invention.”
• A layered approach. No matter what the scenario, data security can’t be ignored, particularly as care extends beyond the hospital walls. Therefore, HMH has taken a “layered approach” by combining the three main triads of security, Reis noted. “As we bring in new vendors and partners, we evaluate their security from an administrative, a technical, and a physical security side, and make sure we’re comfortable with all three.”
• Listening. One of the most important functions of leaders during a disaster situation is to listen — not just to what’s being said, but what isn’t being said,” added Reid. Whether it’s job stress, family concerns, or a general sense of anxiety. “We’re asking people to work really hard and really fast to create an environment where we can treat patients in a safe and responsible way and give them the best care possible. That’s a lot to manage.”
• Leaning on others. When facing adversity, leaders need to practice what they preach by looking to others for support, Reis said. “This is where you cash in the chips of the goodwill you’ve created through prior interactions.” What it also does is show a level of vulnerability and authenticity in senior managers that can help build loyalty, he added.

As HMH starts to move forward — while keeping a close eye on Covid-19 activity — Reis’ team remains focused on maintaining the nimble mindset that has guided it through the past several weeks, and ensuring the underlying technology remains stable and up-to-date.

“The philosophies we’ve put in place and the vendor partnerships that we’ve established have really paid dividends for us,” said Reis. “We’ve been able to meet the needs of the organization, which I think has been noticed by everybody.”