For Jackie Rice, there’s so much more to being a CIO than guiding the technology strategy. It’s understanding how all of the departments work together to ensure patient needs are being met. It’s finding a way to continue the “purpose-driven work” she did during her 20-plus years as a NICU nurse — something she has instilled in her staff at Frederick Health, an organization based along the western coast of Maryland.
Recently, Rice spoke with Kate Gamble, managing editor of healthsystemCIO, about how the pandemic has underscored the importance of building a culture around that purpose, and bringing every initiative back to the patient. She also discussed the “very accelerated pace” her team maintained during the height of Covid-19; how they’re thinking out of the box to lower the risk of phishing attacks; and why she believes healthcare organizations need to embrace data as “one of our biggest resources.”
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- Although Frederick Health is independent, the organization collaborates with the University of Maryland as well as non-profits to better understand the needs of its community and “positively impact the well-being of every individual.”
- For Rice’s team, “the pace was very accelerated” during the height of the pandemic, as telehealth services were quickly stood up across the practices, and smartphones were deployed to enable patients to facilitate communication within the hospital.
- Other initiatives that were stood up to meet the rapidly changing needs of patients included a virtual waiting room, remote monitoring and asynchronous telemedicine.
- Going forward, one of the key goals is to leverage analytics to learn which technologies are being utilized most and will require optimization. “It’s looking at our data and understanding what we need to refine.”
Q&A with CIO Jackie Rice, Part 1
Gamble: Let’s start with an overview of the organization — what you have in terms of hospital beds, some of the other services provided, and where you’re located.
Rice: We are located in Frederick County, Maryland. We are a growing community; we’ve grown 40 percent in the last 25 years. We have about 300 licensed beds and 20-plus ambulatory sites with lab, radiology, and other services. We have Frederick Health Medical Group, which has 100-plus providers. We have a diverse community, with young families moving in, a rural farming area, and a tech corridor.
We opened in 1902 and have been independent since then, although there are more organizations that are merging and being acquired through acquisition. We try to stay on top of that so we can be an independent organization and provide all the services right here in our county.
Gamble: It’s a rare thing now to be an independent organization. Is that becoming increasingly challenging?
Rice: We do a lot of collaboration. We have worked with different programs through the University of Maryland and Johns Hopkins, which are two big organizations in Maryland. We do a lot of collaboration with the nonprofits right here in Frederick to understand what our community needs. I think that is key. The marketplace is ever-evolving and the pace of change is accelerating, but our mission has always been to positively impact the well-being of every individual in our community, and we feel like we can still do that as an independent organization.
It’s important to understand the health equities within your own community, because every community is unique. Being an independent, we’re able to explore and learn from our community about the key health outcomes that are unique to our area. For example, we have a definite deaf population. We have communities of retired people, we have rural areas, and we have a tech corridor. And so we’re always focused on meeting everybody where they are and doing what we can as the only hospital in our county.
Gamble: Can you talk a little bit more about the tech corridor?
Rice: We have MedImmune in the backyard. We have a lot of technology-type organizations that are up and coming here in Frederick County. We’re in that corridor between Baltimore and to D.C., about an hour away from each of those. It’s a good place for those technology companies to land.
The “accelerated pace” of rollouts during Covid
Gamble: Can you talk about how your team managed the many challenges that came with Covid?
Rice: The pandemic was definitely a challenge. The pace was certainly accelerated. We had to meet our consumers and our patients on multiple channels in order to reach them. We brought up our digital platforms within two weeks. We had 100 providers offering telehealth services to the community so that we could keep people at home and safe.
We deployed a lot more with our smartphones so that our patients who were actually in the hospital could communicate with their family. We had a no-visitor policy for quite some time. How can those patients communicate with their families? Some of them had smartphones at home, but in other cases, we had to help facilitate that.
There were more digital initiatives. We had to think about, how do we communicate with patients when we put up our Covid tent and were doing tests? How do we notify them with negative Covid results? We always called those who had positive tests, but we used technology to send texts for negative results. We had Salesforce in the background helping us do self-attestations for our own staff, and to track things like beds and IV pumps. We moved several units around in our hospital to try to plan for the surges that were predicted. We knew we had to track everything, and so we developed a tele-sitter program.
These were all on the horizon, and so we had some of the background work. But the ability to stand that up very quickly and respond to our patients — and keep them safe — was big. Things like, how do we get older patients in to see their doctors so that they can see how they’re doing, even socially and emotionally?
Digital initiatives to improve care
We worked on things like your appointment reminders and virtual waiting rooms that enabled people to stay in their car until it was time to come in. We set up pre-registration to help with that, and looked at ways to keep in touch with chronic patients through remote monitoring. We had a pretty good program set up in which we were monitoring about 100 chronic care patients — those with congestive heart failure or COPD, for example. We ramped that up quickly during Covid; we’re now at 300-plus in terms of the number of patients we’ve been able to monitor at home and keep in contact with healthcare workers, preventing them from having to go to the ED.
The pace was very fast, as we were trying to understand the different things people might want. We also had something called asynchronous telemedicine where, for example, a young mom with a UTI could ask a provider some questions and have those answered, and even get a prescription for medication without having to do an in-person visit. Those are the types of things we tried to provide for the different groups in our community.
Optimizing & refining
Gamble: Right. As you had said, some of these things had been in the planning phase or in early development, so it was a matter of having to turn it around quickly. I’m sure that presented some challenges in terms of resources?
Rice: Yes. Like I said, IT projects have a very definite process where you scope out your project, you identify all the people who are going to help, and you do trials and pilots. We did these things very quickly in collaboration with the people who would be using them. IT is the enabler. We’re putting the tech out there, but we’re also working with the staff that have to use the technology and providing the multiple channels for them to interact with our community. That has been very important.
One of the things we’re doing this year though is to go back and make sure we’re optimizing things like virtual waiting rooms that were put in so quickly. It all goes back to, what’s the best way to do it? What’s the best way to set up preregistration forms? Can we standardize a little bit, especially because we’re putting them in so fast? We want to use our data to understand who’s using the asynchronous telemedicine? Who still wants to use telemedicine and not come in to the office, and who really needs to see their provider face-to-face? We’re looking at our data so that we can really understand what we need to provide and work on refining that.
Adopting a “data-driven culture”
Gamble: Let’s talk a bit more about that. Was there a time once things had slowed down in which you had to decide which initiatives would keep going? How did you assess that?
Rice: We’re still in that process. Our frontline staff is still in that process. We look at the news every day to learn what the predictions are for this year. What are we going to have to respond to? And everybody is very tired. People go into healthcare to provide that care and that touch, but it’s been a very stressful year for our workforce — for the frontline staff and those supporting them. We’re breathing a little bit better now, but we need to see what this impact will be this fall.
We’re trying to adopt a data-driven culture and pull the data together to decide what data do we keep? What meets the needs of people and what doesn’t? Everything has a cost, so what’s the best place to put our funds so that we can provide tools for people across the enterprise and in the community? Because people are communicating with the hospital. People are communicating with the 20-plus sites in our medical group, so what are the best tools to enable that? I’d like to think we can use our data to figure that out and work through it, and so we’re currently in the process of doing that.
We need to embrace that data is one of our biggest resources. At Frederick, we’re in the middle of our data governance and enterprise analytics journey, and that’s one of the things on the dashboard: to continuously improve on where we are now. Hopefully we’ll be able to use those analytics, especially when it comes to the pandemic. Because we’re not at the point where it’s, ‘this is over and we can move on now.’ We don’t know what we’re going to face this fall.
Part 2 Coming Soon…