IT Forefront

Q&A: How CIOs can get ready for a post-Covid-19 world

by Mackenzie Rech and Mark Hetz

Covid-19 has created a new normal for health care organizations, including IT teams. While it is unclear how long this new normal will remain, CIOs must lead through changing times and prepare for what happens after this first wave of Covid-19. We sat down with Advisory Board's Senior Director Mark Hetz to discuss the challenges CIOs must navigate as we look to the future.

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Mark is an industry veteran with over 30 years of experience in health IT leadership. Before joining Advisory Board, Mark was the SVP and CIO at Asante Health System for 24 years. Mark has also served as a founding board member and officer of the Reliance eHealth Collaborative, a statewide health information exchange, and a founding board member of HIT Commons, a public/private corporation established to promote and manage statewide health IT initiatives.

Question: While the pandemic is far from over, many health system leaders are starting to think about what comes after this initial wave of infections. What should CIOs be doing right now to prepare for the rest of the year and beyond as we move past the Covid-19 surge?

Mark Hetz: I see three major buckets of work. The first, and by far the most important, is take care of your people. The IT team has been through a lot and needs your support and leadership. This includes the clinical members of your team who were drafted back to their clinical disciplines, and those who may have felt sidelined because their areas of expertise were not a high priority during the crisis. They all need to know they are valued.  Once you can catch your breath, celebrate your team's successes, even if only virtually. 

Next, work with your leadership team to make a list of the damage needing repair. In the heat of the crisis, a number of policies and procedures were likely bent or broken. Don't let the "crisis way" become the new standard (unless of course it is a better way of doing things). This might especially be true for procedures around user and device provisioning, inventory management, virtual visits, and remote access. As quickly as possible, get your house back in order. But also learn from the experience.

Third, work with your leadership team to assess how much of your organization's newly remote workforce can or should remain remote. Now that the investment is in place, turn it into a financial win.

Q: Most health systems and hospitals are already facing significant financial strains as a result of Covid-19. How will this change how CIOs prioritize projects? And how can CIOs continue to communicate the value of the IT department?

Hetz: Most organizations are likely to fall back to a "financials first" prioritization regimen, where projects that don't have a strong positive return on investment are deferred or canceled. Identify and prioritize the IT projects that leverage the crisis investments you've already made.

CIOs are also going to want to explain how their work to expand telehealth saved the organization money by diverting patients from acute settings and bringing in revenue from what would have been canceled or delayed appointments. They also should be prepared to describe how many one-time and ongoing costs were incurred. It's not a bad idea to produce a one page summary for the IT Steering Committee and the Board. 

That said, tears of gratitude dry quickly. The smart CIO needs to seek ways to continue to save the organization money as we move beyond the Covid-19 crisis. One area to investigate are reduced rental and office space expenses due to the increased remote workforce. 

Q: Telehealth has played an invaluable role in combatting Covid-19. Looking to the future, how should CIOs think about investing in telehealth and other digital health technologies?

Hetz: Before investing more, maximize the return on the investments you've already made and work with your clinical leaders to hold the gains from virtual visits. While the relaxed reimbursement landscape may change over time, the public's desire for this service is not likely to decrease. In addition to holding the gains, work on making incremental improvements to telehealth investments, such as remote patient monitoring. 

Q: There will undoubtedly be a lot of lessons learned from this crisis for all health system leaders. Has Covid-19 brought to light any significant flaws in the way health IT departments operate today?  

Hetz: While every CIO's experience during the crisis has been different, the two areas I consistently hear referenced as weaknesses are the IT supply chain and interoperability. Although not as publicized as the search for N95 masks or ventilators, every IT department's supply chain has been disrupted. The sudden increase in remote work and virtual visits led many IT departments to suffer from shortages of cameras, laptops, and other infrastructure needed to support the transition. Perhaps this was unavoidable, but we can learn from the challenges. Remember the suppliers that had your back during the crisis and the innovative substitutions. 

In terms of interoperability, while the industry has come a long way in the exchange of standard clinical data, the exchange of non-standard clinical data and non-clinical data, such as data on ventilator capacity, is a clear opportunity for improvement.

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