Keeping the lights on: the wiring behind the business of health IT delivery

The COVID-19 pandemic has challenged health systems in 2020 – accelerating the implementation of new technologies, necessitating the rise of employees working from home and causing more patients to need help using new tools to manage their healthcare.

As we at Penn Medicine focused on implementations in response to these new changes, we also knew it was also critical to monitor the pulse of everyday operations and “keep the lights on” in supporting the business of healthcare delivery, research and educational programs.

There’s an art to balancing new innovation while maintaining a high level of technology based service to healthcare users. It requires a solid technology foundation of core systems, adherence to quality controls and an excellent service support model to continually run on all cylinders.

Technology advancements build on foundational systems

The core systems that are essential to operate in a healthcare system includes the electronic health record system, data management and analytic systems and the finance/supply chain systems.

In addition, multiple third-party systems integrate into the core systems to support the organizational operations. The advancements of technology ride on the backbone of core systems that are foundational components for innovation and growth.

Analysts and informatics that support core systems must have a comprehensive knowledge of how the range of systems work from an integrated systems-thinking approach, understanding how the process works across different sections of the organization, and more importantly, what data is captured in these systems.

Having analysts and informaticists with holistic knowledge of the core systems can help healthcare organizations harness the immense quantity of the data for reports such as hospital census, infection rates, supplies, human resource reports and financial projection forecasts. Additionally, data security solutions must be in place, since it is essential to securely examine data in new ways with new tools.

Quality controls enable optimal performance

As projects are accelerated apace, the IT departments must continue to be nimble and demonstrate adherence to quality controls and follow best practice procedures for deployed technologies.

Shortcuts are not a good means to an end – even during a pandemic. Change control must continue in order to monitor and manage the technical environment in the most optimal way. As new records, features and functionalities are added to the systems, it is critical to continuously validate the integrated systems to ensure that high-end meaningful data is being provided.

IT is responsible for multimillion-dollar contracts. It’s important to establish and maintain a solid contract review and renewal processes. Initial contracts should follow an assessment and onboarding procedure based on the organization’s standards of terms.

It is also important to review master service agreements based on your organizational standard. There are two areas that need consideration with contract negotiations:

• Assess annually whether new language needs to be added to contracts (i.e., data use or cybersecurity).
• Look for opportunities to create efficiencies by reviewing the use of the different components of the contract. You may be surprised by the utilization rate of the different aspects of the product and/or system. If there is minimal utilization, contract negotiations need to occur.

Once you have done a few contract analyses, you will have better insight of the potential cost savings per contract.

Service excellence

The key to a successful and valued technology service center is having the ability to solve problems quickly with minimal time and impact to the user. 

When COVID-19 hit and a higher percentage of staff moved to remote work, it tested the bandwidth of our support service areas. With our Service Desk and our Information Services Advisory Center (ISAAC) in place, we were able to quickly scale up to support the additional 325 tickets per day.

Having a service desk that also supports Tier 1, Tier 2 and patient portal calls, it centralizes the communication of the multiple initiatives and allocation of support resources. The ISAAC team provides concierge service for nonurgent IS questions related questions regarding advice, resolution, guidance and follow-up. Having this one-stop contact during the pandemic was most helpful for clinicians.

Maintaining a high performance of systems and results can only be achieved through exceptional passion and commitment from the IT teams, hospital leaders and operational partners. Health systems must continue to keep the lights on for core systems while advancing care delivery, accelerating research and improving the user experience.