The COVID-19 pandemic changed the way healthcare teams operate. Priorities have been upended, resources have been stretched thin and teams are having to find new ways to provide the best care possible for patients. While front line professionals are the face of care during the coronavirus outbreak, healthcare information technology (HIT) leaders have driven the support behind these remarkable individuals to ensure our communities remain safe.

That’s why we’ve been interviewing HIT leaders from across the United States, Canada and Europe to learn about how their organizations respond to COVID-19. During our conversations, these leaders shared their most pressing challenges, advice for colleagues and stories of hope and innovation from the front lines. 

Here are highlights from our third round of interviews, featuring insights from Europeans leaders Jacques Rossler, CIO at Cliniques Universitaires Saint-luc, Kevin Percival, CNIO at Frimley Health NHS Foundation Trust and Pieter Helmons, CPIO at Ziekenhuis St. Jansdal Harderwijk.

To date, what has your team done to respond to the COVID-19 crisis?

Jacques Rossler – CIO at Cliniques Universitaires Saint-luc

“The first thing that we did was change our organization in order to be sure that the whole IT team was not infected at the same time and functioning in the long run. To respond to the crisis, we maintained communication lines with the crisis management committee in order to be able to follow the changes in the hospital wards as they were converted into COVID 19 wards. At the beginning, decisions had to be made by the hour, so we had to be very agile in order to support the organization.

Another thing we did was to implement a remote connection for the workers that were able to work at home, giving them the ability to take over their on-site PC with dual factor authentication. We had to create training and communication materials, as well. We also had to ask people to take on new roles and to be flexible. From the beginning, we were thinking about this as a marathon, rather than the 100 meter hurdles. We knew we were in it for the long haul, so we had to put a solution in place that would be sustainable.” 

Kevin Percival – CNIO at Frimley Health NHS Foundation Trust

“It’s turned our priorities upside down and very much so changed our focus from delivering healthcare in the traditional setting to thinking differently about how we collaborate with our patients. Due to social distancing measures, things like using virtual consultations have really changed the way we work. 

Moving to an online platform has been a huge change, and the shift seemed to happen overnight. Therefore, the demand for technology has been amplified much faster than we would have experienced otherwise. We’ve pretty much done three years worth of work in three weeks.” 

Pieter Helmons – CPIO at Ziekenhuis St. Jansdal Harderwijk

“The supply chain is the most important issue at this stage. We immediately ramped up our supplies to a level that would ensure that we had enough for our patients and for the growing patient population that we were expecting. But we were discouraged by our professional society to stockpile because that would aggravate the shortage issue. Within a week or so, our national society got the approval from our government to coordinate the supply of essential medications on a national level in order to make sure that every hospital had enough.”

What is the most pressing challenge your team currently faces as you respond to the COVID-19 Pandemic?

Jacques Rossler – CIO at Cliniques Universitaires Saint-luc

“The implementation of video consultations because we have to train the staff members who want to start using the technology. They always seem to come to us with a solution they found on the internet, but they are often not secure nor compliant. I think it’s more an opportunity than a challenge.

Now that we are seeing a slowdown in cases, what we will have to coordinate in the coming days is the reconvergence of some of the COVID wards. We had stocked those units with specific materials, such as antibacterial keyboards and mouses, so now we need to be able to collect those items and sterilize them in order for it all to be reused afterwards.”

Kevin Percival – CNIO at Frimley Health NHS Foundation Trust

“I think it’s still catching up with the numbers of requests that are coming through, and certainly some of the challenges of trying to get equipment in. For example, China has only just restarted the manufacturing process. But one of the benefits of the centralized NHS approach is that they have been trying to manage that supply and demand to make sure that distribution is fair, equal and not just based on who put the order in first.”

Pieter Helmons – CPIO at Ziekenhuis St. Jansdal Harderwijk

“We actually have already seen the height of the pandemic. Now, the most pressing issue at this stage is getting regular patient care back in our hospital. We’re experiencing a giant backlog of outpatient visits, off-scheduled ORs, etc. that we need to deal with in addition to the constant presence of the COVID-19 patients.” 

As you look ahead to the coming weeks, what is an upcoming challenge your team is preparing for that you anticipate growing in importance?

Jacques Rossler – CIO at Cliniques Universitaires Saint-luc

“One challenge will be that a lot of people want to get back to the normal operation as soon as possible, but you can’t just switch the situation on and off. We will get requests from people that want everything set and ready to go by tomorrow, and we will need to be able to cope with that pressure. We will have to take a step back to see what is the best for the organization and stay aligned with the corporate pace.

Another challenge that’s specific to our organization is that we had to postpone our Go-Live with Epic. Due to that postponement, we will also expand the original scope of the project. On the other side, the workforce will be exhausted after the COVID-19 crisis. We will have to manage an extension of the scope, more work and people that are just tired because they’ve been working seven days a week ,12 hours a day… 

We have no guarantee that the authorities will continue to finance what we are doing today with video consultations after the crisis. We are creating a new way of interacting with patients, and if the authorities in Belgium are going back to the standpoint they had before the crisis, it will create frustrations at the patient and physician level. If the authorities are now saying, ‘Okay, go ahead!’ then we will also have to cope with the speed of deploying that video consultation and consider whether or not it’s better to wait in order to get it directly into Epic instead of creating something completely different. To know that, I would need a crystal ball, and I don’t have that crystal ball yet.” 

Kevin Percival – CNIO at Frimley Health NHS Foundation Trust

“We’ll be keeping in tune with what the government is doing on their mobile and logistics protocol. When the pandemic ends, it’s all about the number of staff that we’ve had on the ground and the amount of effort they have put in. It’s one thing to put in a good two to three weeks of concerted effort with no leave, but it’s different when you’re talking about six to nine months. How do you keep that constant drive there without over relying on certain individuals in the organization?”

Pieter Helmons – CPIO at Ziekenhuis St. Jansdal Harderwijk

“It doesn’t sound sexy, but it’s the truth: what’s essential is making sure that the stuff is there. You need to make sure that your supply chain is well governed, that you can relate to how your physicians and nurses are feeling, and that you can help to alleviate their workload. We immediately started preparing ready-to-use syringes because that’s what our front line staff really needed.

I think that a sense of agility is something that we will need in the next month. No more piloting video calls with your patients. Just do it! We’re already thinking of doing much more work from home because we’re so used to it now and people are actually quite comfortable with the technology. The good thing about that is that it’s much more efficient. In the very near future, patients will realize, ‘I no longer have to go to that hospital anymore. I can just do the video visit and I’m good to go!’” 

What advice do you have for your colleagues who may not be as far along in their preparation and coordinated response?

Jacques Rossler – CIO at Cliniques Universitaires Saint-luc

“Telework is very nice, but prepare to be inventive in the way you are going to implement it. 

Be prepared to change direction and make decisions very fast. Maybe you will go in one direction one day and the other direction the other day; the only thing that you have to think about is it good for your patients and for your organization.” 

Kevin Percival – CNIO at Frimley Health NHS Foundation Trust

“It’s all about thinking ahead to the next couple of weeks and not just focusing on now. Remember to just take that moment to pause, think about exactly what you’re trying to do and what your exit strategy might look like.

It’s a matter of balancing the demands from different parts of the organization because you still need to strategize about how you’re going to deal with mobilizing in a pandemic world. 

Get the governance right. We are using a gold, silver and bronze approach that’s been highly effective elsewhere in our organization. It allows us to have a single place for quick decision making, while making sure we’ve got the support on the ground to actually back that up and do what needs to happen.

Prepare in alignment with your clinical colleagues around where they’re planning for that increased need for intensive care capacity. You have to think about the things that they’re not thinking about, like how you plan to network in that ventilator or other devices.

Don’t be afraid to challenge when actually it’s not the right decision. We had a situation where a team tried to deploy a video conferencing platform which was being done in an unsafe way and we had to push back. Sometimes, the emotions really get flying during this pandemic. You need to have an honest conversation with people and not be scared to challenge your leaders.”

Pieter Helmons – CPIO at Ziekenhuis St. Jansdal Harderwijk

“Make sure that your data is up to par. We were very fortunate to have dashboards within a day. We were able to see our usage of drugs per floor so we could quickly top up our supplies. The other advice that would give, especially to pharmacists, is do not strive for the ‘A’ or the 10 on a scale from zero to 10. A six or a seven is good enough. Make sure that you strive for an acceptable service level. That’s very difficult for pharmacists; we really are perfectionists.”

Can you tell us a story about someone making a difference in your organization or an innovative idea that has grown out of the challenges your team has faced in the past few weeks?

Jacques Rossler – CIO at Cliniques Universitaires Saint-luc

“We had a request from our nurses to provide tablets to our patients so that they can communicate with their families. We realized that this would be a challenge because then you have to sterilize all those tablets as they go from one patient to the other. Instead, we had iPhones and healthcare grade covers on-hand that were ready for Epic Rover, and I asked my team to repurpose those. Sure, it’s not a tablet, but it does work and the patients were so happy. The lesson for me was to think out of the box and reuse your materials.” 

Kevin Percival – CNIO at Frimley Health NHS Foundation Trust

“We had to stop allowing visitors to see patients basically overnight. Over the course of about four hours, my team and I were asked to deploy the video consultation platform that’s currently in place at our organization. I woke up the next day to a message from the relatives of a patient who said that the technology gave them the opportunity to see their mother die. That was really inspiring to me. What we originally saw as a problem that needed solving has actually had a huge impact. Outside of COVID-19 precautions, people that wouldn’t be able to see their relatives before because of barriers like distance now could. It has made the world a much smaller place through the use of assistive technology. It  doesn’t matter if you’re two or two hundred miles down the road – the same service is there.”

Pieter Helmons – CPIO at Ziekenhuis St. Jansdal Harderwijk

“We transformed a situation into an enormous opportunity. We were planning for years to support our ICU nurses with ready-to-use syringes so that they can fill syringe pumps immediately without having to draw up mixtures. 

We were fortunate – if you can call it fortunate – that our chemotherapy compounding pressure immediately decreased because of the fear that chemo patients should not get treatment in the time of a pandemic. We then had some capacity that we could immediately use for our syringe compounding. It’s not only the sense of satisfaction that comes from the nurses expressing gratitude to us, but also the feeling that it gives our team to know that they could actually do something, that they could contribute. I think that is something that really stuck with us because we did not really realize how much other teams rely on our service.

The community support is enormous. We were given these flowers, hortensias, and there ended up being about 3,000 of them in the central hall of our hospital for every care provider to take home. Every day we have something – free lunches, ice cream bars, yogurt. People would even gather outside the hospital at night and applaud. It gives such a sense of community and a central, warm feeling that’s an energizer.”

The Pandemic Response Continues

Thank you to all of the HIT leaders who took time out of their busy schedules to speak with us about their efforts to support the front lines during COVID-19. Stay tuned for more updates from the front line as we discuss pandemic response with more HIT leaders.

As your team formulates their response to today’s changing healthcare environment, Alidade Group is ready to help. Our experienced consultants are available to assist with enhancing systems and workflows to meet your evolving needs. If you’re looking for a partner to help meet these challenges, contact our team at https://alidadegroup.com/contact-us/.