In the last week of August, the Delta variant of the new coronavirus accounted for 99% of Covid-19 cases across the country, according to data from the Centers for Disease Control and Prevention. For hospital leaders — including the chief medical information officers who sit at the nexus of clinical care and technology — this worrying jump in cases has resulted in a challenging summer.
CMIOs at provider organizations are trying several strategies to deal with rising caseloads that might get worse as schools open up in much of the nation following Labor Day.
They include reinforcing IT tools and services, such as clinical documentation and remote patient monitoring, in addition to contending with new issues like helping create a Covid-19 booster vaccine plan.
Owensboro Health has been deploying tried-and-true strategies to manage surges in cases, such as converting units to accommodate Covid patients who need to be isolated, said Dr. David Danhauer, CMIO of the Kentucky-based health system, in a phone interview.
This meant that the IT infrastructure supporting these activities also had to be ramped up or, in some cases, redeployed.
Danhauer’s team has been especially focused on the IT services that surround Covid testing and patient documentation, including ensuring bidirectional data exchange with Kentucky’s health information exchange. The IT team’s priorities appear harrowingly similar to last summer.
“Covid is just eating up our IT time right now,” he said. “We’re redoing what we undid…[but] it did make it easier that we had done it before, and we had that information built in the background.”
But there are new challenges as well, including needing an action plan for providing vaccine booster shots. The government announced plans to begin offering mRNA vaccine booster shots this month, though now federal health officials are advising scaling back those plans, according to The New York Times. Still, given that regulators are reportedly considering offering Pfizer booster shots sometime soon this is something providers need to begin preparing for.
“[My managers] are trying to hammer out [plans for] the booster dose,” Danhauer said. “The recommendations associated with that, how we are going to manage that in our EMR…just so we can get the technology right depending on what the government wants us to do, what our state wants us to do and then what our organization wants us to do. It’s a very fluid IT problem for us right now.”
As resources once again become strained, another key focus for CMIOs is maintaining the infrastructure that enables at-home care for both Covid and non-Covid patients.
“The biggest thing that [CMIOs] can do [to help their organizations] is to look at technology as a way to project the hospital outside of the four walls of the bricks and mortar that we have,” said Dr. Neri Cohen, former CMIO of Greater Baltimore Medical Center Healthcare. Cohen left the role late last month and now serves as president of HealthTek Consulting.
By building up their remote care infrastructure, hospitals can save space in their facilities for patients who are severely ill or deteriorating fast.
GBMC Healthcare is using several platforms, including the Epic Care Companion tool, to monitor Covid patients. It also has a care management team that is focused on continuity of care after discharge, Cohen said.
The technology behind the evolving needs of the pandemic is just one of the issues CMIOs have to grapple with. Another is helping the manage the narrative of the pandemic.
CMIOs are in a unique position to offset and correct misinformation, Cohen said.
False or exaggerated information concerning Covid-19, its treatment and the vaccines that can help prevent it has hampered the management of the pandemic since it began. CMIOs sit at the junction of technology and clinical operations, allowing them to lead or be a part of initiatives around using tech to circumvent misinformation, Cohen said.
While at GBMC Healthcare, Cohen and his team focused on providing information through the health system’s website, webinars and town meetings for employees. Further, Cohen did talk show and radio interviews to help spread accurate information among the public.
As the pandemic evolves, so does the role of the CMIO — a belief held by both Cohen and Owensboro Health’s Danhauer.
For example, CMIOs will no longer be required to only oversee the minutiae of building order sets and setting up EMRs, Danhauer said. Instead, they must focus on advancing the clinical use of IT.
“As we move forward, the CMIO is going to have to be more strategic and not in the weeds as much,” he said.
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