In recent months, some have referred to the rapid adoption of digital health tools as a “silver lining” of Covid-19. Aaron Miri, however, sees it a bit differently. He believes the pandemic has “galvanized and rallied everybody around common causes of humanity,” and has helped increase awareness of healthcare IT’s critical role in care delivery.
“You have to be in the pilot’s seat,” he said during a podcast interview. “If you’re not, the ship is going to crash.” And that doesn’t just mean being in the trenches with your team; it means ensuring they know the value of the work they do, and that it’s appreciated.
For Miri, that opportunity came a few weeks ago when Texas faced massive power outages and severely cold temperatures, forcing leadership to – once again – pivot quickly to make sure frontline workers received adequate support. Recently, he spoke with healthsystemCIO about the challenges in dealing with a crisis on top of a crisis, the “little things” leaders can do to boost morale, why it’s more important than ever to set the right tone when it comes to work-life balance, and how he hopes IT will be able to leverage the “goodwill” it has built during the past year.
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- The reason why UT Austin was chosen as one of Texas’ vaccine hubs? “We have capabilities in these facilities, and we have the people,” and therefore are able to make quick decisions.
- Although challenges still remain in terms of managing Covid, it’s important to recognize how far organizations have come in a short time, and the critical role IT has played in the delivery of care.
- In the coming years, CIOs and other leaders will “have the ability and the bank of goodwill built up to drive innovation,” but it has to be approached the right way.
- As a leader, know that your teams are always looking to you to set the tone, which means “you have to be in touch with every level of your organization.”
- The bright side to experiencing a storm within a storm is the ability to provide a playbook for other organizations.
Q&A with Aaron Miri, Part 2 [Click here to view Part 1]
Gamble: The ability to administer vaccines before they went bad — that really takes some quick thinking, and a willingness to shift and say, ‘okay, let’s do this.’
Miri: That’s exactly right. And they had to go out in 5 degree temperatures with 2 inches of ice on the ground and 8 inches of snow on top of it and trek across campus to get to the dorms and administer these.
Because, as you said, the vaccines were going to go bad. We’re administering Pfizer vaccines, and they have to be stored in ultra-cold freezers. If you lose power to an area that have those freezers, it’s not like you can just put it in a fridge in someone’s dorm. It takes special equipment.
The reason why UT Austin is one of two vaccine hubs for central Texas and Travis County, is because we have these capabilities in these facilities, and we have the people. Most of our clinicians have come from other places across the country like Boston and San Francisco that have phenomenal healthcare institutions. And so we’ve created this synergy of really driving forward and helping the rest of campus to make these quick healthcare decisions.
UT Austin has always been phenomenal for research and academics and everything else. So if you add now the two worlds together, you have a bolus of people who are truly are the brightest of the bright, and who truly are here with one single purpose in mind, which is to make this place better. Then you’re able to do say, ‘Okay, let’s administer these vaccines to students.’ No questions asked, just trek out in the elements and make it happen. That’s awesome. You can’t comprehend that level of sophistication until you see it. Once you see it, read about it, and hear about it, you’re like, now I understand. That’s what this place is.
Gamble: As far as vaccination efforts, did that slow down? Where are you with getting that out?
Miri: The airport was shut down for a couple of days, and all of the planes were being diverted, and so the state froze our vaccine allocation. But then we started getting a lot of it. We started getting catch-up shipments, and two things happened. One, the federal government opened up the floodgates. We started noticing we were getting more and more. The state had been holding them because we couldn’t get the trucks out safely. So now it became, ‘take the boxes and the additional allocation, plus your normal allocation, and go.’
We’ve got a good amount of allocation of vaccines, but it’s still not enough. There are waitlists of tens of thousands of people who have signed up. The more vaccines we get, the more we can administer. I’m sure there’s a tipping point where you have to have enough nurses and doctors to administer them. We’re not there. We can easily see several thousand more people a day if we had the allotments. Give credit to the state though, they’re trying. You can see that the wheels are cranking and the federal officials and state officials are definitely talking and trying to make it happen.
There are other challenges of vaccine administration outside of just the vaccine like data and interoperability and sending data to the state immunization registry. But those had been long reported on, and it’s just public health needing to get funded more appropriately. But I don’t want to take away from the men and women on the on the front lines who are making it happen.
Even though we sometimes read about the bad stuff that happens, quite candidly, the reality is that you have an army of healthcare professionals literally doing everything they can to get through this pandemic. All of us are tired and we want this to be done. We want to go back to being normal, at least somewhat.
Gamble: Whatever that looks like.
Miri: Right. Whatever that looks like, we want to go back, and we’re getting there. We’re making progress. You and I spoke last April, and it was a very dark moment for Austin, because the projections for potential casualty rates were so horrifically high; and tensions were high. We were watching the news and seeing the Mercy Ship being docked in New York City; just horrific scenes. I think we as leaders should take a look in the mirror and see how far we’ve come. We’ll also realize how much less hair we have and how much more gray we are.
But beyond that, how far we’ve come from an IT side and how much we’ve matured. This has galvanized and rallied everybody around common causes of humanity and making sure we understand the importance of healthcare IT to the delivery of overall care. CIOs have to recognize that, and make sure their organizations understand the importance that IT has a voice at the table. If your organization isn’t there, there are a lot of other questions you need to be asking. But to the degree of it, I believe most healthcare delivery organizations, whether it be provider, payer, or whatever, now realize and really truly see the instantiation and the value of healthcare IT done right — and of course, the value done wrong; the true cost of ownership.
This is such an opportunity. I’m very bullish going to the next decade. CIOs, chief digital officers and others now have the ability and the bank of goodwill built up with professionals, clinicians, and surgeons to say, let’s try these technology pieces. And just two years ago they would have been reluctant, because we thought, who’s ever going to use telemedicine? Who would ever want to connect over Zoom to do a psychology consult?
Now it’s part of the lexicon. We have such an opportunity as CIOs to drive the next decade of innovation, but it’s going to take us truly getting over ‘this is the way it’s been done before’ and making sure we embrace the way it should be done for the benefit of our patients and our clinicians. We have to.
Gamble: These are really good points. It is pretty amazing when you look at where we were in April. It was a dark time; no one knew what to expect. We had just been hit over the head with this. But things have come so far, and we need to make sure we keep going in the right direction.
Miri: We do. I’m pretty active in social media and I try hard to be very candid and remind folks that this is very difficult. This is not easy. There’s no playbook on how to do this. No one learned this in graduate school. There’s no MBA class said, ‘One day, you’re going to be part of a pandemic response. This is what you have to do.’
You don’t get those lessons learned. I think that’s why a lot of us gravitate to healthcare. You’re not a factory line manager; you’re managing a living organism. You’re managing humanity and emotions and patient care. You’re managing all of these things that technology interweaves between. You have to have a true fundamental grasp on what that takes to do that. More importantly, you have to have a grasp on your humanity and your ability to engage, motivate and drive your staff forward.
In one of our discussions, I mentioned that your teams are always looking up at you, and watching your tone in how to read things and what to prioritize. As a leader, you have to be in touch with every level of your organization, no matter how big or how small. If you don’t, you’re going to disconnect with them. They’re not going to follow you into the fire. You want them to run to the fire, not away; they’re not going to do that if they don’t trust you.
It is a lot for CIOs to have to translate a true clinical item into something technology related and make it resonate with folks, so that they do give up their Christmas Eve or their Thanksgiving or their New Year’s Eve or their weekends here, or they’re here on Super Bowl Sunday like we all were. And I was with them in the trenches setting up a vaccine clinic. That’s what it takes. And whether it’s an ice storm, whether there’s vaccines, whether you’re dealing with Ebola or any of these crazy things that happen in healthcare, it is up to us. You as the CIO have to be in the pilot’s seat. If you’re not, the ship is going to crash. That’s just the reality of it.
Gamble: Kudos to your team and to the entire organization for weathering another storm. It has to give a lot of confidence to the people in the community that health organizations can weather these storms. That’s big.
Miri: I think it does, and it speaks volumes for institutions like UT Austin, Cleveland Clinics, Kaiser Permanente or any established organizations that truly anchor their state and their community, and represent it with pride. They wear their colors with pride, putting the football nomenclature aside, which obviously we’re big passionate fans of college football.
But we have pride in the state of Texas. We’re here for the city and the state. We’re here to teach. We’re here to make a difference. Every one of the fundamental organizations across the country have that ethos. When I was in Boston, seeing the pride for Harvard, MGH, or any of those institutions was incredible.
To your point, yes, it builds a lot of confidence, but it also is an anchor for the community. That’s what we do. That’s who we are. That’s why we’re here. That’s why we bleed orange and why I wear my Longhorns pin. It’s a sense of identity and it’s a sense of humanity. As technologists, sometimes it’s hard to see that, to get your head out of the day-to-day of servers and networks and applications and cloud. Those are all important. But at the end of the day, you’re establishing a tone. You’re establishing a technology ethos. You have to have the same pride in your technology stack as you do in the organization and in your staff. And as CIO, you have to link all of those layers together. If you’re able to do that, that’s where you earn your seat at the table and where you have a voice.
Gamble: Absolutely. This has been great, and I really appreciate you being able to jump on a call with everything going on.
Miri: It’s good to learn from these experiences. Because unfortunately, there will be more disasters across the country, and other CIOs who have to endure tornadoes, hurricanes, and fires. Some of the stories I heard coming out of the Pacific Northwest last fall from CIOs who dealt with wildfires were just amazing. I have friends on the space coast and in Miami; what they go through during hurricane season with evacuations is part of their way of life.
There are things that CIOs — and all leaders — can learn from these discussions. I think that’s critical because it becomes a playbook ultimately of how someone weathered this before — how we dealt with an ice storm in Austin. It will happen again; it’s inevitable. Being able to talk about what we did is so important.