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Forced Innovation: LessonsLearned From a Virtual Go-LiveSes s ion # 179 | Augus t 12, 2021
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Chief Medical Officer, Bay and Thumb Regions, McLaren Health Care
Norman Chapin, MD
DISCLAIMER: The views and opinions expressed in this presentation are solely those of the author/presenter and do not necessarily represent any policy or position of HIMSS.
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Meet the Speaker• Joined McLaren Health in September
2018, following four years at Spectrum Health in Grand Rapids in several corporate quality and safety roles
• Majority of his professional career was spent practicing emergency medicine in the Hudson and Mohawk River Valleys in New York State
• Main administrative and leadership interests are Quality Improvement, High Reliability science, Lean Healthcare Management, and Just Culture implementation within medical staff processes
Chief Medical Officer, Bay and Thumb RegionsMcLaren Health Care
Norman Chapin, MD
#HIMSS21
Conflict of Interest
Norman Chapin, MD
Has no real or apparent conflicts of interest to report.
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Today’sAgenda 3 Lessons Learned from a Virtual Go-Live
Learning Objectives and Background2
Q&A4
1 Meet the Speaker
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Learning Objectives• Analyze the factors that led the leadership team of a large, multi-site healthcare system to
move forward with the implementation of communication technology during a pandemic
• Identify the key steps taken by the healthcare delivery organization and technology vendor to accommodate remote workflows for a project traditionally done with extensive in-person interaction
• Arrange a multidisciplinary team of stakeholders to guide design, implementation, effectiveness, expansion, and quality assurance for a similar project
• Predict how the forced innovation described in this presentation might have implications for the future of healthcare technology deployments
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About McLaren Health Care•
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• Implementing clinical communication platform (PerfectServe) systemwide• Complex project—requires extensive planning, input from many different departments, buy-in
from staff up and down the chain of command• Not unusual for a project of this magnitude to last several years from start to finish
• Began second quarter of 2018• Goal was to finish before the end of 2020
• Five phases total
• Final phase most complex: four 200- to 300-bed hospitals in Bay and Thumb regions
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Project BackgroundConnecting Care Team Members Across the System
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• Experienced a sentinel event related to communication failure• Key reason McLaren chose to implement new communication platform
• Over the course of one year, four McLaren regions deployed the clinical communication and collaboration (CC&C) system• From Gartner: “CC&C systems are IT systems deployed by healthcare providers, and used by
clinicians and support staff, to communicate and collaborate on patient-related activities. They are used to share patient information, capture alarms and notifications, and optimize care transitions and patient throughput.”
• Timely execution of each planned deployment phase was crucial because CC&C and EHR rollouts were happening in tandem
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Communication Failure Spurs ChangeBecomes Impetus for System Revamp
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• Technology implementations are never easy, even in normal times
• Facilities on lockdown due to COVID-19—wondered if the implementation could/should be continued• Could this be done virtually when previous phases required a heavy on-site
vendor presence?• What parts of the process needed to be rethought?• Would we be able to hit the same KPIs using a remote implementation model?
• Also risked losing ingrained knowledge on the project team if progress was paused or delayed
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COVID-19 Changes the LandscapeUncertainty Calls for Forced Innovation
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• Realized a CC&C solution was necessary to facilitate safe, reliable, and effective communication among clinical staff• Dr. Chapin’s experience with Ebola in 2014
• Despite challenges associated with implementing a complex project remotely, determined it was necessary to forge ahead
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Communication is Mission CriticalEspecially During a Crisis
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• Many internal resources working from home, furloughed, or on shortened hours
• A few people on-site rounding, but CC&C team could only help from a distance
• In a matter of days, both sides redesigned entire launch strategy• Teamed up to drive engagement and training remotely during final phase
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Project RedesignRequired Completely New Approach
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• 26 Zoom sessions to train super-users, who then trained their colleagues• For few on-site, continuous rounding to make sure questions and concerns were answered
• Dedicated four-digit phone extension• Immediately connected with PerfectServe team after saying “help”
• Video chat bridge open from 7 AM to 10 PM each day and daily calls held for key stakeholders
• Zoom link active for 24 hours a day the week of the go-live
• On-call consultant provided for nurses
• Detailed FAQs and tip sheets tailored to unique needs of McLaren users—incorporated as many McLaren-specific workflows as possible
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Remote StrategyWorkflows Optimized for Remote Execution
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• Stating the obvious: Biggest challenge was convincing McLaren team to move forward during the pandemic—other projects had been put on hold
• Technology implementations of this size and scope almost always necessitate a steady on-site presence from the vendor• Not easy to take a leap of faith during a public health crisis, but uncertainty is conquered with
careful planning
• Reworking of logistics was onerous• Entire go-live evaluated from start to finish—processes that usually require on-site interaction were
transitioned to 100% virtual support format
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ChallengesTaking a Leap of Faith
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• New technology always faces resistance—some people just don’t warm to new processes as quickly as others• Influential internal project champions were tapped to bring peers onboard—physicians
typically listen well to other physicians
• Best to view challenges as opportunities for improvement• No blueprint for success• Turning dozens of established processes on their head to make them virtual, instant, and
more efficient was exhilarating
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ChallengesInternal Resistance
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• The virtual CC&C go-live saw success in several ways:• Key adoption and utilization metrics• Organizational peace of mind and process improvements for patient safety
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Success Across the Board
95% 22795 percent of registered providers had their schedules entered in CC&C system by first week
• Critical component of success since schedules are constantly referenced to route communications
227 interactions were initiated on launch day—more than double the expected 100
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Success Across the Board
0% 88%Communications that experienced routing errors after first week of usage and optimization• Great start considering more
than 90 different physician groups were consulted to build routing rules
88% of core providers were registered on launch day
• ”Core” = credentialed physicians who do lion’s share of admissions
• Vendor’s typical threshold is 80 percent
• Another key metric since new admissions drive many communication workflows
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Success Across the Board
<5 min $$$Usage has remained high since launch, and the platform has driven increases in efficiency
• Retrieval time for all communications was five minutes or less over half of the time
• In July, over 8,000 interactions were initiated
• ICU care team has used the platform most, initiating over 1,200 communications in July alone
Pivot to remote work also saved thousands upon thousands of dollars in travel expenses
• Vendor team did not need to be on-site
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• Healthcare can be—and should be—flexible and adaptable• Process changes of this magnitude are never easy, but change during COVID-19
has been fast and furious
• A go-live project of this size can absolutely be done virtually• But you need to have a small in-house crew involved and on-site to be facilitators
• Keep the project moving• There will always be pushback and resistance to change, so work with a team who
can push forward by influencing difficult providers
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What We LearnedChange Can Be Good
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• Physicians tend to listen to other physicians• Make sure you have physicians on the project team who are willing to influence their peers
• Make sure your people know exactly how to get help• Can mean creating lots of signage or disseminating other resources internally
• Find the right technology partner• Work with a trustworthy vendor who will be available to your project team and staff 24/7,
rain or shine
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What We LearnedHelp Your People, Help Yourself
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• On-site accessibility has always been crucial part of deployments
• As it turns out, the team is more accessible in remote format• Not traveling, flying, moving from site to site, etc.
• Same quality, potentially better outcomes, delivered in a way that’s more efficient and less costly for all
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What We LearnedMore Accessible, Better Results
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• Basic building blocks of any virtual go-live should include:
• Scheduled training sessions for super users (think Zoom)
• 24/7 access to your technology partner’s support team
• Quick and well-defined troubleshooting pathways for staff in the field
• Heightened presence from your own IT staff to be proactive in uncovering problems or questions
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You Can Do This, TooWhat to Consider
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• Insufficient internal support• Without broad buy-in, prospects for success take a hit
• Unreliable technology partner• Find a partner who can weather bumps, goes the extra mile
• Resistant providers• Those resistant to new communication workflows can hinder results—
recruit dynamic leaders to evangelize change
• Other pitfalls: incomplete planning, lack of on-the-ground IT support, poor internal project visibility
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Potential PitfallsDon’t Get Tripped Up
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• Karmanos Cancer Center go-live
• Already complete, but second CC&C go-live done virtually
• Specialized cancer care environment
• Much easier to connect with 6,000+ practitioners within the McLaren network
• CC&C embedded within EHR
• Places CC&C platform within the EHR environment
• Allows users to quickly compose, transmit, and view messages containing relevant patient information
• Eliminates need to toggle between applications
• Makes care team collaboration easier
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What’s Next?Further Expansion and Optimization of CC&C Platform
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Questions
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Thank you! Chief Medical Officer, Bay and Thumb RegionsNorman Chapin, MD
McLaren Health Care
linkedin.com/ in/ nchapinmdREMINDER: Pleas e take a few minutes to complete an online eva lua t ion for this s es s ion!
