As we continue to manage uncertainty around the Covid-19 pandemic and settle into to our new normal, one thing is certain: Work life is being redefined in healthcare.
Organizations scramble to deal with the challenges of shifting to remote work for the majority of employees, including clinical teams. Some have struggled. Others have been nimble enough to deliver a secure, seamless, and consistent environment for their staffs to access critical systems and data, no matter where they are.
IT leaders have had to ask themselves a number of questions: “In our organisational strategies, can we find a way to future-proof our systems?”
“Will we leverage the experience of our successes and failures to build enterprise strategies that can withstand the next pandemic, natural disaster, or even simple operational initiative? Will we see an increased focus on remote visits, not only for clinician and patient safety concerns, but also, as an attractive alternative to normal in office visits?”
In this blog post, I’ll cover these and other topics, with insights from Dr. John Podkowa Jr., DO and CMIO (Chief Medical Information Officer) with Southcoast Health System. Southcoast Health is a nonprofit, community-based health system with multiple access points offering an integrated continuum of health services throughout southeastern Massachusetts and Rhode Island.
Southcoast Health System General Internist and CMIO Dr Podkowa has amazing insights from the patient care perspective and the technology implementation vantage point. Technology can be implemented to bridge the gap between practitioners and overarching organizational initiatives. I have known Dr. Podkowa for more than ten years, worked with him professionally, and trust his expertise spanning the various spectra of the modern healthcare landscape. And you could say I trust him with my life: He has been my primary care physician for most of the time I have known him.
The continuum of care has seen increased challenges during the coronavirus pandemic, and it has stressed already-overwhelmed physicians. Not only are they trying to remove the normal barriers to patient care such as transportation challenges, language barriers, and struggles with compliance to clinical directives, but they are facing new issues. Some are related to coronavirus, such as patients foregoing needed visits and/or treatments, or the fear of contracting COVID-19.
Like many organizations around the U.S. and around the globe, Southcoast looked to technology to help overcome challenges for their patients and clinical staff. That meant implementing drive-up screenings, leveraging wireless infrastructure, using the Citrix platform to access EHRs and clinical apps, or serving patients via telemedicine, whether from home, or from their offices.
In many instances, physicians were even providing remote visits to their patients from their home offices. “With the large concentration of elderly and other high-risk patients such as those with heart or respiratory issues, it is important to continue to manage those chronic conditions, while still safeguarding these populations from elevated risks associated with the possible exposure to the virus,” Dr. Podkowa says.
Telemedicine is gaining more traction out of necessity. Additionally, insurers are adding more procedure reimbursement options, so healthcare organizations now have additional resources to add to their arsenals that enable them to provide improved patient care.
“The majority of providers are interacting via some form of telemedicine, whether it be video, phone or some combination,” Southcoast Health System General Internist and CMIO Dr Podkowa. As for whether we will continue to see the widespread use of these technologies, he added, “I do see a hybrid model; there is a portion of visits that can be safely handled just as productively — if not more so — via telemedicine.”
“There are also large underserved communities that could really benefit from the expansion of the practices. Many may not have easy access to doctors and care, whether it is primary care or, in many cases, the specialists who might be hours away in metro areas,” said Southcoast Health System General Internist and CMIO Dr Podkowa.
These new approaches will deliver benefits to patients and physicians. Think of the time saved on the patient side with a follow-up visit conducted via video conference, rather than making a round trip to a clinic or physician practice. Not only do both the patient and medical provider maximize their time, but also, alternative methods of caregiving will likely improve attendance and compliance with clinicians’ directives.
“While being mindful of the present conditions, we need to identify successful processes, and document these for future reference,” says Dr. Podkowa, noting successes in collaboration across clinical, technical, and even organizational boundaries.
“Doctors are talking within their own organizational teams,” he says. “In addition, they are conversing with their peers around the world.” He adds, “We do not solve these problems in a vacuum, so we need to work together as a community. We truly are better together. With improved access to healthcare, we will hopefully see significantly better patient outcomes,” said Southcoast Health System General Internist and CMIO Dr Podkowa.
Collaboration: A Key to Success
Collaboration was a key success factor in dealing with the sudden shift in strategy to business continuity and work-from-home initiatives and is necessary within the healthcare ecosystem (administrative, operational, and IT leadership) and with strategic third-party vendors. At Citrix, we are proud to serve as a trusted advisor to many healthcare organizations. We pride ourselves on delivering reliable integrated solutions to enterprises — solutions that allow quick adaptation to this ever-changing environment.
With Citrix, Southcoast was able to efficiently pivot to a work from home strategy — with minimal ramp-up time to support the needs of caregivers. “It was unbelievable how seamless shifting to a remote or work from home/business continuity scenario was with Citrix,” Dr. Podkowa says. “The technology allowed us to move quickly.”
“It was remarkable,” he says. “I believe this transition saved lives and enabled better care and more positive outcomes. The ability to work remotely was and will continue to be a lifeline for organizations. This kind of digital solution will be a ‘must have,’ rather than a ‘nice to have’ moving forward.”
While the Citrix solutions at Southcoast proved to be a sound investment, some greeted the implementation with skepticism early on. “Cost and complexity were key concerns, but now, it is easy to see the value for the present and the future,” Dr. Podkowa says.
Resilient, Scalable, Nimble
Southcoast’s strategy was to build an architecture that was resilient, scalable, and nimble enough to deliver core resources in any scenario. Whether it’s a merger and acquisition, a natural disaster, or a situation like the one we’re in now, the ability to pivot in real time was paramount in the design of the hospital’s vision.
“Our IT team’s foresight enabled access to all of our solutions, not just to our EHR, Epic. This included HR, Purchasing, and more, and allowed us to pivot the entire organization in real-time to work from home,” Dr. Podkowa says. “The investment has paid off — clinically, financially, and operationally.”