For the past few years, we’ve seen a significant evolution in the role of the CIO. And although it isn’t always obvious, there are times when it couldn’t be clearer just how much has changed. Case in point: Aaron Miri, who has held the role at Dell Medical School at the University of Texas at Austin for the past two years.
During a recent interview about his team’s efforts in response to Covid, he expressed the same passion while discussing the human aspect of leadership as he did while talking about the groundbreaking 3D-printing face shield imitative. When it comes to managing people, Miri believes the need to “tough it out and soldier on” can hinder relationships, and that during difficult times, it’s important to “be vulnerable” and “talk to your team in a way they understand.”
He also talks about how the innovative culture at UT Health Austin has enabled his team to flourish, their strategy when it comes to contact tracing, the enormous potential telemedicine offers in terms of health equity, and why he feels like two years has “flown by.”
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- It wasn’t a “magic pill” that helped flatten the curve in Austin, Texas area; but rather, a “comprehensive” response by health systems and the local public health authority.
- For IT leadership, holding “stand-up calls” every other day with physicians, nurses, and others has proven critical in keeping all departments informed on key matters.
- At one point in late March/early April, UT Health Austin was down to just 17 days of availability with PPE. Four weeks later, a solution was in place: 3D-print, custom-fit masks.
- Innovation is part of the culture at UT Health Austin, where all are encouraged to “Take calculated bets, fail fast, figure out whether something is viable, and go blaze new trails.”
Q&A with Aaron Miri
Miri: I’ve been in health IT for quite some time and this has probably been the most intense, interesting, fearful, frightful, and anxious but successful period I’ve ever seen in terms of what technology can bring to the table in terms of enablement. It’s something where all of us are going to look back and shake our heads. But I think for those of us who are going through this right now in our careers, we’re going to come out the other side with some fantastic new ideas that maybe we wouldn’t have adopted initially, because we were so comfortable with the way things were.
The other thing that’s been beautiful to watch is the startup industry. So many startups have been successful and have grown because they’re able to morph and pivot to help with the Covid response. It’s been really nice to watch as our industry grows up.
Gamble: That’s a very apt way to put it. I definitely want to get into some of the ways in which your organization is leveraging innovation to deal with the challenges of this unique situation. But first, what is the status of Covid in your area?
Miri: Austin is doing great as a city. As the students returned to campus, there were concerns about 18-year-olds and their ability to self-isolate and mask. But putting that aside, the city has done fantastic. In terms of the public health response, I give a lot of credit to the local public health authority and local health systems like ourselves, as well as Ascension, HCA and Baylor Scott & White, in educating the general public on the importance of washing your hands, keeping a safe distance, and just being mindful. Because of that, Austin has seen a decline in terms of positive results and numbers of folks being admitted into the ICU and into more acute levels of care because of Covid. All of that is due to public effort. There is no one person or one magic pill that you can take and have all of this get better. It’s been a comprehensive response.
In addition, there are some fantastic partnerships. Dell Med and UT Health Austin have teamed up with public health for contact tracing. We’ve done contract tracing of large swaths of the population to help people understand that they may have been exposed, and they need to self-isolate, and that’s been very helpful. All of those efforts together have really helped Austin as a whole. It’s been great to watch.
Gamble: It sounds like health systems are really working together and are focused on doing the right thing.
Miri: That’s correct. And again, I give a lot of credit to the physicians. It’s been amazing to watch. We have a stand up call every other day, first thing in the morning, with a number of physicians from across numerous health systems to share what’s going on: what has worked and what has not worked. That physician partnership, as well as the organizational partnership, has really been the lion’s share of our success. I give so much credit to physicians, clinicians, nurses and students for literally banding together and making things happen for the benefit of the public and the patients we care for. It’s why we’re in medicine. We want to enable our physicians and clinicians to be successful and effective with technology and watch them do their magic and do what truly is heroic work. It’s amazing and I’m blessed to be part of it.
Gamble: Let’s talk about the face mask initiative utilizing 3D printing. That seemed like a very cool initiative. Can you give some background as to how it came about?
Miri: Back in March and April, it became clear that the PPE being used by clinicians were in short supply. In fact, during one of our stand-up calls our chief clinical officer mentioned that we were down to about 17 days of PPE availability at the health system, and we were having very difficult times sourcing alternatives. At the time, the situation looked pretty grim in terms of our forecasted potential casualty rates for the summer. The fact that our clinicians were not going to have PPE, or were being forced to reuse it, which is even more dangerous. I thought, ‘I’m at the University of Texas at Austin. There must be a way to create something that’s just as effective and just as fast, if not faster, that can help prevent some sort of positivity or virus transmission. We have to be able to do something for our clinicians.’
As we looked into it, I contacted the UT engineering school — which is one of the best in the world — and said, ‘I have the idea. I have the wherewithal. I have the bandwidth. I have the clinicians in need. I need you guys to help me solve this problem.’ And they did.
And so, literally over a period of four weeks, through a partnership with some major technology companies, we were able to do the facial scan. We were able to 3D-print custom-fit masks, leveraging a standard 3M filter, to filter the 0.2 microns necessary to protect against the virus. I can’t call it N95 because it requires FDA certification, which it’s now going through, but it’s better than your typical physician/clinician face mask that’s not N95. And so, to a degree, it really pulled us through a pinch.
Fortunately, the PPE shortage issue nationwide alleviated a few months into the pandemic. We still equipped all of our physicians with masks, because they go through normal N95 masks and face shields very quickly. And so the ability to 3D-print those materials using a design that works and a design that’s been tested, has been huge. We’ve done the normal Bitrix test where you spray the mask to make sure nothing leaks. We’ve done all the various isolation mask protocols necessary, and it’s passed with flying colors. We feel comfortable in that. If, in the event we don’t have an N95 available to you, you could switch to this without a problem.
Our protocol for it was actually interesting. It came from some of the frontline clinicians — who, I’m proud to say, we enabled from the beginning. We gave them one 3D printed mask for non-Covid, one 3D printed mask for Covid, and one hot spare. That way, at any given time during a shift, they have three masks they can rotate through, and when they get home they can toss them in a dishwasher or washing machine. Even when you autoclave these masks 30 to 50 times in a row, which we did, there was no problem.
The physicians really liked that. The other thing is that N95 masks can become really uncomfortable, particularly if you have interesting facial features, because they are form-fit to your face. The masks we created can fit even the most oblong noses and all the other things that make us unique, because it’s made specifically for you.
So it was a great initiative. It was fun to see UT come together. We’re still working on it and still refining it with better materials, but the whole point is to get it out there at cost and at scale, so we can help people. It’s not meant to be anything other than an alternative. We’ve had some of the largest health systems in the country engage us because they want to start equipping their clinicians with these masks, and so we’re helping them now.
Gamble: Something like that can really make a difference. We always hear about how the goal is to provide clinicians with the tools they need to do their jobs effectively. Particularly with how things are now, the last thing you want is for clinicians to have something else to worry about.
Miri: You’re exactly right. At that, our clinicians are already worried about infecting their families and neighbors; they’re doing everything they possibly can to keep themselves and keep their loved ones safe. For me personally, if I could have done something to help them — in this case with 3D printing — and I didn’t, I wouldn’t be able to sleep at night. We can solve this problem; just because it’s never been done before, doesn’t mean that we can’t do it.
Gamble: That’s big. It speaks to the spirit of innovation and being able to not just say, ‘hey could we do this down the road,’ but being able to get to work on something right away. It seems like it has to be part of the culture.
Miri: It does. One of the reasons why two years at UT Austin has flown by in the blink of an eye is because they encourage you to be bold. It’s why this is one of the top 10 public schools in the country and top 30 in the world; because of that mantra. Take those calculated bets. Fail fast. Figure out whether this is viable and go blaze new trails. When you have that as an ethos as an academic health system, everybody rallies around it. It’s okay to throw a Hail Mary football. It’s not shunned. It’s not frowned upon. Be smart and do the right things, but take a Hail Mary especially when there’s a situation like this where your back is pressed against the wall. What we’ve seen over and over again with Covid, when you read the success stories across the country, what we’ve been talking about at a federal level with HITAC (Health IT Advisory Committee), has been these success stories of people leveraging technology to do amazing things. We have numerous stories like that coming out of UT Austin. I’m proud to look at the team and say, ‘I’m part of this.’ I’m blessed to be part of this.
Part 2 Coming Soon…