Communication is an essential part of leadership — particularly during a crisis. There’s no disputing that. But in order to have a real impact, it must go beyond merely speaking with your direct reports. It’s about empowering directors and managers to communicate with their teams. Because the reality is that, as a CIO, “there’s a limited audience” you can reach, said Michael Saad in a recent interview.
Saad, who serves as CIO at University of Tennessee Medical Center, believes that, when given the right opportunity, individuals will “step up and shine.” He’s seen it happen, especially during the past few months. In the interview, Saad talked about his team’s strategy in response to Covid-19, why data is “the new oil,” how vendor relationships have changed, and the “new normal” healthcare leaders can expect going forward.
- About UTMC
- “Decisions were made within hours and IT had to quickly respond”
- 3 key areas of focus: remote work, telemedicine & analytics
- Having “the right protocol and gates in place” to secure data
- Success with telecommuting – “We saw some measurable productivity gains.”
- Enlisting the CMIO to work with physicians & IT staff
- Shift toward consumer engagement
- Leveraging “actionable data” to guide decision-making
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A lot these decisions were made within hours; IT had to quickly respond and adapt to ensure we could provide operational support throughout the hospital and the clinics.
If people feel disconnected from their peers and their management team, that’s a recipe for disaster. We realized up front that communication is critical.
So many other industries have been tailored around consumers; healthcare hasn’t really done that. I think this is a great step toward allowing access to care when the patient wants it and needs it, and not necessarily around when the provider can do it.
A lot of the data is below the surface; you have to mine for it, you have to explore it, and you have to bring it up to the surface and refine it. But once it has been extracted and refined, that data is invaluable.
If every morning when you wake up there’s an email in your inbox that has a Tableau dashboard showing all of our analytics for the last 24 hours and predictive analytics for the next 24 hours, that’s much more valuable than you having to ask for a report.
Gamble: Hi Michael, thank you for taking some time to speak with us. Let’s start with an overview of the organization.
Saad: University of Tennessee Medical Center is a 685-bed hospital. We have a number of regional health centers and about 55 clinics. We support a 21-county area in east Tennessee. We are the region’s only level 1 trauma center, and the only academic medical center in the region.
Gamble: What’s the status as far as the pandemic? What are you seeing at this point?
Saad: We are located in Knoxville, Tenn., which fortunately has not been hit as hard as other parts of the country. I have former colleagues I speak with on a regular basis at Henry Ford Health System in Detroit, which is one of the epicenters. They’ve had a really tough time. We have very minimal cases in comparison to other locations.
Gamble: What was your strategy in response to the pandemic?
Saad: When all of this started, I don’t think any of us really knew how large the pandemic would be, especially on our region. We saw the news out of New York, Detroit, New Orleans and Washington State — I think all of us were prepared for the worst, and that was absolutely the right thing to do.
Similar to other hospitals across the country, we prepared for a large influx of patients. In the state of Tennessee, we were ordered by the governor to stop all elective and non-essential surgeries. That allowed us to basically shift all hospital operations to focus only essential care and potential COVID patients.
A few operational things happened as a result of that. One, we stood up a very large tent outside for Covid-19 screenings, which helped keep patients out of the emergency room. We didn’t want patients who thought they had COVID or suspected they had Covid to possibly infect others. So we made that tent into a screening area where we could test patients and do triage.
We also took a lot of our units throughout the hospital and identified them as Covid units. They were private rooms that in many cases were set up as negative pressure rooms from an infectious disease perspective. A lot these decisions were made within hours; IT had to quickly respond and adapt to ensure we could provide operational support throughout the hospital and the clinics.
Gamble: So there was a lot happening, right from the get-go. What were your main priorities when Covid first hit?
Saad: There were three distinct areas we focused on. The first was supporting remote workers. Up to this point, we had just a small contingent of folks working remotely, and it was very easy to support; they had access to dedicated systems. But almost overnight, we had several hundred—if not almost a thousand — employees working from home. That was a huge scramble on the IT side, as you can imagine.
We had to procure equipment. We didn’t want folks taking desktops home, which would create logistics issues from an inventory perspective. So we quickly had to procure laptops and mobile devices. The challenge is that we were competing with every other hospital across the country to purchase equipment. Fortunately, we were able to get the equipment we needed to support our remote workers.
Then there was the connectivity piece. First we had to enable access to systems and make sure we were inventorying which systems were needed and figuring out how it could be done securely. It’s challenging from a cybersecurity perspective when you go from a handful of people accessing the systems remotely to nearly a thousand. That’s a huge increase, and a huge uptick in the number of ingress points within the network.
And so there was a big cybersecurity push to make sure the devices being used remotely by folks on the inside were secure, and that the data being transferred into that was secure, and we had the proper protocols and gates in place to keep things protected.
The last piece of supporting remote work is communication. As anybody who works remotely understands, communication is critical. If people feel disconnected from their peers and their management team, that’s a recipe for disaster. We realized up front that communication was critical in the success of this.
We did everything we could to rule out tools that let teams continue to collaborate together, whether it was through Microsoft Teams or Zoom. When people work virtually, we want them to feel like they’re within a quick distance of anyone who needs to reach out and talk — and not just those within the same department, but throughout the organization. We moved management briefings and meetings to a virtual platform so that people could more easily communicate.
Gamble: It’s a really big change to go from the office setting to your house. You really have to make an extra effort — especially in the beginning — to make sure people are aware of those communication channels, because it’s just not the way people are used to working.
Saad: Exactly, and part of it is education. For some people, technology is more intuitive, while others need more hand-holding. And so we were trying to work through that as well.
Gamble: So there’s really a lot that goes into supporting remote work.
Saad: Absolutely, and we’re going to continue to do that even when we’re passed the pandemic. This has been one of the positives to come out of Covid. We’ve seen some measurable productivity gains across the board, as well as an increase in satisfaction from an employee perspective. People like not having to commute and having the flexibility of being at home, and so that’s something we’ll continue to do and support going forward. And actually, I think that’s a huge win in the healthcare space.
Gamble: I agree. There were a lot of misconceptions that people can’t get things done if they’re not in an office.
Saad: Exactly — ‘If I can’t see you, you’re not working.’
Gamble: What were some of the other areas of focus for IT?
Saad: The second was telemedicine. We have a state Medicare program that didn’t reimburse for telemedicine prior to Covid — that really inhibited our rollout. If you can’t get reimbursed for it, there’s not a whole lot of incentive for healthcare organizations in the state of Tennessee to roll it out en masse.
We had a strategy in place to go forward once the state legislator and private payers approved reimbursement. Clearly we didn’t anticipate that a global pandemic would free up the payment structure for the federal government, state government and private payers, almost overnight.
Once that barrier was eliminated, we were free to proceed. We went from having really no telemedicine program to having a working program that all the providers were trained on in less than two weeks. That was incredible — to stand up an entire, functioning telemedicine platform that works with our billing system and is a satisfier for patients in less than two weeks. We’ve partnered very closely with our chief medical information officer, who did a phenomenal job working with the physicians and the IT staff to help roll this out as well. I think that partnership is absolutely critical.
Gamble: What were some of the challenges you ran into as far as rolling this out in such a short amount of time?
Saad: Some of it is education. I think some physicians are more adept than others at using the technology. It’s a different way to practice medicine, frankly; for some providers it’s more intuitive, while for others may have struggled a little more at the onset to figure out how to provide care virtually and remotely compared with being in the office, and not having that touch or that personal care.
I think as we continued to roll it out, it became more and more popular, definitely amongst our patients. The survey results we’ve received have been very positive, and so our intent is continue the program for as long as we get reimbursement. Fortunately, Blue Cross Blue Shield of Tennessee recently announced plans to cover telemedicine in indefinitely, which is fantastic. It means our patients will be able to get the type of care that they need and deserve.
Gamble: That’s great. Hopefully it will become a trend.
Saad: Yes. Frankly, I think consumers are going to demand that. They want to have access to the providers when they need it. People are raising kids at home or taking care of elderly parents or running households — they want convenience. So many other industries have been tailored around consumers; healthcare hasn’t really done that. I think this is a great step toward allowing access to care when the patient wants it and needs it, and not necessarily around when the provider can do it.
Gamble: It’s interesting. I mean, it’s been talked about for so long, and you see these starts and stops, but I think we’re finally reaching a turning point with telehealth.
Saad: I think so too. It’s exciting.
Gamble: So now, in addition to telecommuting and telehealth, what’s the last area of focus?
Saad: The last area is analytics. I know that’s a buzzword right now and it can mean different things to different people. But throughout this entire pandemic, the data guided our decisions. The data were absolutely critical as we made decisions as to what units to open or transition to Covid units, or even to track Covid trends in our state and our region. How many patients do we have on ventilators? What’s our ventilator supply? How are we tracking PPE? What about other pieces of medical equipment?
Data has become extremely valuable to us during the pandemic. Analytics took a step forward in a number of areas and helped ensure all the data provided were used to navigate and to operationalize and run the hospital.
I heard a quote recently — I think it goes back almost 10 years — that data is the new oil. It’s very relevant in the fact that a lot of the data is below the surface; you have to mine for it, you have to explore it, and you have to bring it up to the surface and refine it. But once it has been extracted and refined, that data is invaluable. We really found that to be the case throughout this pandemic. Operations for the entire hospital was run off of the data that IT was able to extract from various systems — and a lot of those systems really don’t talk to each other. That’s an issue we have today that still needs to be dealt with: interconnectivity, or lack thereof, with a number of these systems. We had to pull data from all these disparate systems and bring them into a single usable dashboard that folks could understand even if they didn’t have an IT background. And it had to be actionable; users have to be able to look at the data and make decisions based on it.
The other piece is automating it. It’s great to have data, but if you need to say, ‘hey Michael, I need this report run,’ it’s not as usable as when it’s automated. For example, if every morning when you wake up there’s an email in your inbox that has a Tableau dashboard showing all of our analytics for the last 24 hours and predictive analytics for the next 24 hours, that’s much more valuable to you than you having to ask for a report. It’s placing the data into the hands of individuals who need it, when they need it. And that’s very important.