The COVID-19 pandemic has been a double whammy for Jack O’Hara, CIO of Springfield Clinic. O’Hara was still adjusting to being a brand-new CIO in a new state, when he had to mobilize a team to rapidly deploy telemedicine in a rural community. He did the latter in a span of three weeks.
“We had a zero remote culture up until two weeks ago,’’ says O’Hara, referring to mid-March, when the pandemic began ramping up and people were starting to work remotely. “My first six months [here] feel like six years. I really got thrown into the fire.”
O’Hara became CIO of Springfield Clinic, a $1 billion healthcare system with 400,000 patients and 3,000 employees, in Springfield, Ill., last summer. By Nov. 1, 2019, he had rolled out an updated billing system, which he says is the biggest upgrade you can do in healthcare. “There was lots of complexity, but it was great to build camaraderie and trust with the team,” he says. In February, IT moved the hosting of its electronic health records system to the clinic. That was “also a once in a 20-year project,’’ he says.
Then came the coronavirus in March.
O’Hara had just finished laying out a 12-month strategy to deploy a virtual desktop infrastructure (VDI) so people could eventually work remotely — just as people began working remotely.
Today, Springfield Clinic has at least 500 employees working remotely, although that figure is growing.
VDIs have become one of the essential tools in the playbook of CIOs who are now leading in the biggest crisis they’ve ever faced. But technology aside, some IT leaders have changed how they approach their roles and have learned things about themselves and leadership that they didn’t know before the pandemic began.
Recognize the humanity of all involved
When remote work kicked in a few weeks back for staff at IDB, a New York-based private and commercial bank, one of the first things IT did was move physical desktops to VDI. That enabled almost 700 employees to connect to the corporate network and still operate effectively, says Dave Smithers, CIO and COO.
But another priority has been to focus on the health, well-being and safety of staff, Smither says. “We put in a notification protocol with HR so if anyone’s reporting [an issue] we can track it and make sure they’re getting all the help and assistance they need.”
Now, using IDB’s mass communications tool, which Smithers says is designed for use specifically during crises, officials are sending SMS texts and emails to ascertain people’s locations and well-being. Employees are asked to confirm they are healthy and safe, he says, especially since New York City has become the epicenter of the coronavirus.
“One thing I’ve stepped up more is asking people about their personal situations and we’ve really pivoted and said, ‘Are you working a schedule that works for you?’” Smithers says. “I have young kids at home and get up at 4 a.m. and have shifted my workday a little to find a temporary new normal so I can also support my family.”
He’s also doing one-to-one calls with senior leadership and is reinforcing the message that flexibility is paramount right now. “Some of my staff will start working at 8:30 at night and that’s their new normal, and we’ve have had to adjust to that a little to accommodate them,” he says.
Commit quickly — and provide ongoing support
Springfield Clinic’s O’Hara knew telemedicine needed to be implemented, but he had to start from scratch. On March 20, his team started looking at telehealth and technology vendors. The big vendors were overwhelmed and not getting back to him, he says, so O’Hara chose one the same day that was smaller “but had great customer service.”
The following Monday O’Hara’s team tested a video visit. “What I wanted was a one-touch button for patients’’ to make it as easy as possible for them since some may be elderly or disabled, he says.
O’Hara discovered the workflow with the system was taking too long, and decided he needed to go with a different, larger telehealth vendor. The one he found, he says, told him they were bringing on 25,000 providers worldwide in a day.
His team began testing that system the morning of March 24 and had it up and running and doing three or four telehealth visits that day, he says.
“Now, we’re doing 15 to 20 [telehealth visits] a day and that number is growing exponentially because we’re bringing on three to five physicians a day,’’ he says.
Most of the operational issues that have arisen have been less about technology and more about doctors and patients becoming comfortable in a video conference, O’Hara says.
“There’s website manner, like bedside manner — you would be in a room with a physician for your visit and wouldn’t answer your phone, but we’ve seen patients answer their phone on a visit,’’ and sometimes doctors too, he notes.
There have also been a few instances where someone would set up an elderly patient for a telehealth visit, and although they like it because it’s easy to use, “when they have to download things, it’s just challenging. It adds another layer of potential failure,’’ O’Hara says.
Ramp up communications
Matt Lamb, CIO of Rosendin, a $2 billion electrical contracting company in San Jose, Calif., is also a new CIO, although he’s been with the company for five years. That familiarity gave him confidence that systems were in place when he assumed his new position seven months ago.
“Certainly, it’s a whole new ballgame right now … getting 3,000 end users set up and working remotely’’ who hadn’t before, Lamb says. “From the get-go, I was confident we were ready to go and had systems in place, but that didn’t mean it would happen while I stepped back.”
Communication, Lamb says, is a critical part of a crisis management playbook.
“From day one, I’ve been providing leadership for my team, motivation, support and in being in the office, showing I’m there with them,’’ he says.
Lamb has also upped communications with Rosendin’s global business users “and put myself out there and let them know IT is there,’’ he says. “We’ve given people tips and tricks for working from home and [information on] the collaboration tools we have.”
He and his team are also sending out a lot more emails to provide user guides and links to YouTube videos.
While Springfield Clinic’s O’Hara says he understands there’s a lot of risk for staff being in a healthcare facility right now, he’s focusing on having people who are willing to go all in. “I’ve given [IT staff] the option to stay on the sidelines,” he says, but “I need people to lean into the challenge right now.” That includes continuing to work nights and weekends, like they did to rapidly get the telehealth system up and running.
Rethink your organizational structure for speed
Other healthcare CIOs have also learned that everything has to move at a much quicker pace. Laura Wilt, system vice president and CIO of Ochsner Health, in hard-hit Louisiana, says that when the pandemic came to New Orleans, hospital officials quickly moved to 24/7 coverage and opened new units and converted others to critical-care units.
Ochsner added over 100 ICU beds in two weeks across the organization, so the majority of Wilt’s staff have been spending their time deploying equipment, including telemedicine, so nurses and physicians are able to communicate with patients without having to go in their rooms, she says.
But even prior to that, the hospital went to a command center model, which for Wilt, meant redeploying IT people “to be collocated and entirely focused on one topic: COVID-19.”
Her team also set up a system incident command center to centralize communications for different internal groups quickly. “You really staff that like incident response,’’ Wilt says. “You take away responsibilities and move them to other people so those people are entirely focused on COVID-19,’’ Wilt says.
Any time new beds are added or changed to critical care, IT has to be ready to equip them right away with the appropriate systems for care and communications, she says. A command center approach “allows for adaptable and rapid response.”
Springfield Clinic’s O’Hara echoes the need for speed over perfection, noting the kinds of quick decisions that must be made in a crisis — like reassigning the project manager for the telehealth project to a different role and moving someone else in. “It wasn’t that she wasn’t good, I just needed a rock star to move this at lightspeed,’’ he explains.
While he typically has a “more democratic, participatory leadership style,” O’Hara says he’s also learned that “I need to do command and control in crisis mode. You can’t go around the room and see what people think.”
Meet frequently — for purpose and morale
Like Rosendin’s Lamb, Wilt says constant communication has become even more important now and she holds daily meetings with all directors and above in IT and weekly meetings with her entire staff of 150 people on Zoom, “to keep communications open, and make sure we’re answering questions and talking about what’s going well and staying connected to each other.”
It can be lonely and isolating for people who are used to being in an office every day to suddenly be home and not seeing their peers’ faces, she says. “I asked all my leaders to see their teams once a week via video because it’s not the same when you talk on the phone,’’ Wilt says. “I see my direct reports every day on video.”
At the same time, Wilt has discovered that she’s had to change her feelings about meetings. “I’m one of those people who says if there’s not a topic we need to cover we’ll cancel it. That’s been difficult, because people have a need to have consistency and be able to see each other,” whereas when they are in the office every day they “can chit chat in the hall.”
But now, Wilt will hold a meeting even if she doesn’t have things to discuss “so people have the opportunity to talk about what they need to. I think it’s been very important.” A big part of the agenda is “doing a lot of recognition” of people who are doing outstanding things and sharing patients’ stories to make sure everyone feels connected, she says.
Although Ochsner’s staff has been prepared, given that New Orleans has had to contend with other crises, like hurricanes, “this particular crisis really highlights that no one has all the answers, and we still have to move forward without knowing what things will end up like,’’ Wilt says. “There’s no playbook for this. You really have to try to instill trust in people you work with that we’re totally committed and in it together and we have to help each other.”
Find champions for co-creation
Before joining Springfield Clinic, O’Hara worked at Mt. Sinai Medical Center in New York City. Moving from a large research hospital to a physician-owned clinic required learning how to interact with physicians, “who are essentially running 500 small businesses, as opposed to working for a behemoth of a company,” he says.
This presented issues when it came to agreeing on one telehealth platform, he adds.
“I really figured out as a leader, my product has to be so good they won’t ignore me,’’ he says. “I have to build up stakeholders and physician leaders and that’s what I did.”
O’Hara says he convinced three physician stakeholders among the leadership team to sign onto early testing of the telehealth platform. That way, they could participate in demonstrations to the rest of the physicians.
“Previously, they thought … you tell [IT], ‘We need this,’ we build it and it’s there,’’ O’Hara says. “But having them in meetings made them part of co-creation and that’s really important for building trust.”
Consider what you can control
Like many CIOs, Jon Cosson, head of IT and CISO at wealth management firm JM Finn, had to get employees working remotely in a few days’ time. The lesson, says Cosson, is “you cannot underestimate the value of investing in the right technology infrastructure before you need it.”
The COVID-19 pandemic is just another situation where so much is out of our control, he notes. “We can’t control what’s happening in the stock market, we can’t control what is happening around the world, but we can enable our company to continue operating remotely and supporting our clients with the same high-quality service we always have,” he says.
Because JM Finn already had VDI in place, it wasn’t too much trouble to move about 400 staff to remote work, but configuring dealers and traders, whom he calls the “power users,” was.
“These power users were more complex to get set up as they use powerful, process-intensive machines that require lots of storage and memory, with zero lag or downtime tolerance, and [they] require about four to eight screens each,’’ Cosson says. “This is the first time all our power users have all worked remotely, and something many of our peers are struggling with at the moment, given the demands of this set up.”
The focus then became supporting employees and maintaining business continuity with technology that is not just easy for end users, but also secure and powerful and complies with regulatory requirements, Cosson says. “In just a few days, we were up and running remotely, and to date, our team has received extremely positive feedback on how the remote setup is working.”
Embrace the adrenalin rush
For some CIOs, leading in a crisis is an opportunity to rise to the occasion. “I kind of enjoy being in crisis mode,’’ says Rosendin’s Lamb. “It’s taxing … but there’s a thrill and the rush. You get to put a lot of your skills to use and there’s something at stake you’re going for.”
He views the pandemic as a chance for IT to shine. “In order for us to be successful working from home, it’s IT’s responsibility and I want to do my part to keep things going,” he says.
There’s also the sense that there will be comfort in being calm. “The most important thing people have looked to is calmness in leadership,’’ says IDB’s Smithers. “These are trying times for many people and the situation has worsened, so it’s important to remain calm and assemble facts and try to pull together a plan … and being okay changing plans.”
Echoing Ochsner’s Wilt, Smithers says he’s learned that people like constant interactions and being able to see him and read his body language, so he’s doing more video calls than normal. People take strength from seeing their leaders be calm and measured, Smithers adds.
Those constant connections have helped assure people that “together as a group, we’ll be that much stronger,’’ Smithers says.
His biggest challenge has been more about finding the right work/life balance. “I have two kids under five and a Labrador,” so they don’t necessarily understand boundaries, he notes. “My daughter has made a few guest appearances on video.’’
Thrills aside, Lamb has also taken away something more personal from this experience: “getting out of denial when you see [the virus] happening around the world, and it gets closer and closer’’ to home, he says. “I probably needed to be a week ahead of where I was when it all came down.”
And Lamb is coping just fine as a new CIO thrown into the fire.
“I’ve been in IT a long time and have had management positions, and the CIO I’m following taught me a lot … and prepared me in a lot of ways for this. There’s a high-stakes game now and I fell in and I haven’t really been too fazed by it.”