When health systems sent thousands of employees home last March to work remotely, it didn’t just change the game for IT and security leaders; it reinvented the game. And the playbook that was in place to provide adequate support and enable an optimal user experience had to be torn up — or at least drastically altered.
“Even though we’ve been closing buildings and reducing our footprint for facilities, we’ve actually opened up 40,000 remote offices,” said Jim Brady, PhD, VP of Information Security and Infrastructure & CISO at Fairview Health Services. And while Brady was referring, in fact, to the number of individuals employed by Fairview (rather than physical offices), it still created a tremendous burden for those providing support.
During a recent webinar sponsored by ThousandEyes, a part of Cisco, Brady spoke about the challenges Covid-19 has posed from a network availability standpoint, along with Gordon Groschl (Director of Infrastructure & Cybersecurity, Texas Children’s Hospital) and Myles Angell (Director, IT Infrastructure & Operations, Baystate Health).
Not only did it mean managing more calls, but also a wider range of issues that needed to be resolved, noted Groschl. “With remote work, all of a sudden these standard processes that are tried and true and have been used for many years basically become obsolete, because you’re dealing with all these different variables.”
And having a “much more diverse service portfolio to support” means leaders need to adjust their processes, he said.
According to Angell, the first hurdle came in making the decision to send 3,000 employees home, and then manage the transition. “One of biggest things was communicating who would be working remotely and when,” he said, adding that many of his managers had little or no telecommuting experience. Not only did leadership have to ensure individuals had the workstation or devices they needed, but also a reliable Internet connection.
“We have a fairly large footprint. Everybody was doing the best they could to get through the day, and the week,” Angell noted. “As we were moving folks off site, we were also trying to make sure the in-person experience was optimal.”
At Fairview, leadership addressed bandwidth concerns by switching to a cloud-based VPN, which helped enormously, said Brady. When telehealth adoption spiked, the organization leveraged its virtual desktop infrastructure (VDI) to enable clinicians to access the information they needed to provide care from any location.
“There’s a whole host of things that make that home office more challenging,” he noted. “It’s a different way of working.”
And it’s one that requires leaders to be able to pivot and take the necessary steps to support those on the front line.
The new game plan
Those steps, according to the panelists, included (but were not limited to) the following:
- Securing the right tools. At Texas Children’s, a task force was created prior to the shutdown that included representatives from human resources, clinical, and IT. “A lot of processes needed to be put in place from an HR standpoint to manage the logistics of moving thousands of people offsite,” said Groschl. Along with granting access to remote tools, it also meant enabling multifactor authentication (MFA). “We did a whole campaign around MFA to make sure everybody’s ready to go so that when we pull that trigger, we can minimize the impact to our end-user community.”
- Troubleshooting at the next level. When most staff were still based in offices, “the conversations were easier in the sense that they were monitoring the data center. They were monitoring the network. Most problems could be traded back to the workstation,” said Groschl. And so his team has ironed out the troubleshooting methodology by leveraging knowledge-based articles and playbooks to address requests. For instance, the first step is to ask about the individual’s location, and based on the answer, go through a series of questions to isolate the issue.
- Working with Teams. Texas Children’s began using Microsoft Teams as a “multi-platform service for conferencing, chatting and storing information,” rather than just for IMs among staff members. The organization also created a channel that enables the service desk to interact with network security and platform engineers, and more easily refer issues to them when needed.
- Situation management. Along similar lines, Baystate is leveraging Teams to speed up diagnostics, particularly in cases where the same issue has been presented multiple times. “We need to ask, ‘What are we missing from our user experience?’” noted Angell. “If we’re getting 50 people asking for something, we shouldn’t treat it as a single thing, but rather, look at the big picture.” In addition to supplementing the service desk with IT staff to help triage calls, his team has also developed a “robust situation management process” that leverages on-call paging platforms to more quickly reach solutions.
- Bots to the rescue. When the pandemic first hit — and things became “real” — the biggest burden was on call centers, according to Groschl. One way to alleviate that? By utilizing bots to triage telehealth visits and help screen individuals before in-person visits. “Bots were a big aspect of us transitioning from a traditional customer service model to a more digitally enabled customer service model.”
- Looking and detecting. The most effective way to remedy an issue, according to Brady, is to nip it in the bud, which he hopes to accomplish by administering health checks. “We need to make sure we’re not spending all of our time on preventing things from happening, but actually looking and detecting,” he said. “That’s really important, especially in security.”
- Expect a learning curve. Like many pediatric organizations, Texas Children’s hadn’t done much in the telehealth space prior to Covid. And so, due to a lack of proper physician training, along with the proper support structure to translate business processes into a remote consult, the learning curve was steep. What Groschl found, however, is that the problem was less about technology and more about operations. By using a hybrid cloud model, “we were able to scale up very quickly,” he said. However, “getting the organization to adjust their business processes was a challenge.”
What they quickly found was that when things start moving fast, there’s a ripple effect that must be dealt with. “With Covid, the demand for business solutions rapidly increased, as did the speed at which we were expected to deliver,” said Groschl. “We were forced to change our architecture, and so we really started embracing cloud and using it as a toolbox to deliver business value.”
The change to an “agile scrum, rapid deployment model” is one he believes will be permanent, lasting long after the pandemic has subsided. “We’re not going to return to where we were before.”
Brady agreed, noting that his team is also driving more toward the cloud, whether it’s infrastructure as a service or software as a service. “The old architecture is just not going to work,” he said. “As we talk more about what needs to stay on premise and how we can get out of the data center business, we need to adopt a cloud-first mantra.”
Finally, leaders should bear in mind that communication is everything, said Angell. “You can build it, but that doesn’t mean they’re going to come. We’ve spun up so many different pieces of technology and there’s overlap because people don’t know what we have.” The ultimate goal, he said, is to ensure staff can easily view the options and access information on how to solve a particular problem. “We can do a better job of making sure our teams are giving answers to our partners in a way that they don’t have to submit a query; they just know where to go.”
To view the archive of this webinar — Ensuring an Optimal User Experience for Patients, Remote Clinicians & Other Employees (Sponsored by ThousandEyes, a part of Cisco) — please click here.