How a pure catastrophe spurred one supplier to optimize its IT with managed providers

California’s Santa Rosa Group Well being, a federally certified well being heart, serves greater than 40,000 uninsured and underinsured folks within the better Santa Rosa space.

THE PROBLEM

In 2017, the Tubbs Hearth destroyed 6,000 properties and the supplier group’s largest well being heart, which served half of its sufferers. The devastation traumatized employees, sufferers and the neighborhood. It took months to place out the hearth, and Santa Rosa Group Well being needed to reorganize on a dime.

“We opened three new websites inside 4 months, one everlasting and two short-term, and needed to create a centralized name heart,” mentioned Naomi Fuchs, CEO of Santa Rosa Group Well being. “We confronted inner IT challenges and monetary pressures as we redid our telephone and laptop techniques and opened these new clinics.”

Add to the situation citywide infrastructure harm and outages.

“Since we’re in a high-risk wildfire zone, our electrical firm proactively shuts down energy with solely 24 hours’ discover,” Fuchs mentioned. “We now have turbines available at our three largest clinics. In 2018, we evacuated for per week and arrange our administrative providers some other place due to close by wildfires. Then, in 2019, our newly rebuilt Vista clinic opened. Shortly after, we confronted extra wildfires within the space, after which a worldwide pandemic in 2020.”

For years, the clinics have been plagued with persistent telephone issues, bandwidth issues, storage issues and connectivity points. As a healthcare supplier, it in fact depends on its digital well being document. When this software program frequently freezes or does not work proper, suppliers and employees cannot do their jobs and sufferers get annoyed.

“Quite a few weekly outages and a whole lot of energetic, unresolved IT work tickets posed a possible well being hazard to our sufferers,” Fuchs defined. “For too lengthy, we discovered ourselves patching holes, moderately than addressing root causes. We desperately wanted an IT service supplier to rework our ailing IT atmosphere, all whereas conserving clinics open for sufferers.”

PROPOSAL

Managed IT providers vendor HBNS steered Santa Rosa Group Well being tackle the basis problems with the IT instability in order that the supplier may create a more healthy, extra dependable, environment friendly and economical IT atmosphere that would reply to the neighborhood’s wants.

HBNS needed to standardize tools and system configurations, automate behind-the-scenes processes for faster repairs and troubleshooting, migrate some off-site servers to the cloud for better flexibility and catastrophe restoration, and supply proactive, on-site technicians.

“Knock on wooden, it has been fairly quiet for the final a number of months by way of IT points. Now we’re methods to make use of extra distant know-how and combine our medical and dental EHRs.”

Naomi Fuchs, Santa Rosa Group Well being

“We wanted a collaborative, problem-solving accomplice as a result of healthcare IT is advanced,” Fuchs mentioned. “It requires a breadth of experience from infrastructure and community structure to knowledge administration and assist desk help. We contracted out to HBNS moderately than develop an IT division as a result of that is not our experience. Our prime precedence was to be accessible 24/7 for our sufferers.”

MEETING THE CHALLENGE

First got here supply of IT providers. Fuchs mentioned the primary six to eight months was a painful time.

“HBNS found many hidden points with our older, misconfigured and under-maintained {hardware} techniques, together with an absence of correct documentation and passwords,” she recalled. “Our software program had bugs and our community was wonky. We might been rising so quick that we had a hodgepodge, or Winchester Home, of IT issues.

“HBNS introduced a spirit of collaboration and partnership to their work with our inner employees and exterior distributors,” she continued. “They did not simply repair the most recent downside; they examined the entire system and addressed the basis trigger. They centered on constructing an infrastructure that was secure and sturdy.”

Second got here related operational reporting. The EHR had glitches. The supplier makes use of the eClinicalWorks EHR and Related Well being data-reporting software program day by day. These techniques typically failed, or took so lengthy to course of that they did not meet practical wants.

“HBNS, our inner EHR crew and medical high quality groups collaborated with distributors to deal with the problems by optimizing your complete atmosphere,” Fuchs mentioned. 

“Earlier than that, the Related system struggled to course of the crucial day-to-day operational studies for the suppliers and nursing employees. The studies would both take eight to 10 hours to course of, would crash, or each, inflicting the studies to be unavailable to employees the following day.”

Now the supplier group generates studies in 18 minutes. Which means clinicians have up-to-date details about healthcare gaps for sufferers on the time of care, and the group can observe progress towards high quality objectives on the affected person in addition to inhabitants degree in actual time.

Third got here {hardware} substitute and an atmosphere rebuild. When HBNS first began, Santa Rosa Group Well being was up towards a problem of older {hardware} that had reached efficiency capability and was getting older out. The supplier additionally had many points with the way in which the techniques have been initially constructed and configured, inflicting operational points.

“We did not wish to buy new {hardware} for our off-site servers, which might have been a big capital expense, however the older servers weren’t addressing our knowledge administration wants,” Fuchs mentioned. 

“HBNS labored with inner groups and exterior distributors to rebuild and migrate 37 bodily servers to an AWS cloud-based atmosphere. Migrating to the cloud permits us to shortly ramp up or down primarily based on our IT useful resource wants.”

Among the software program distributors on the servers embrace Microsoft Nice Plains, eClinicalWorks, Related, Microsoft SharePoint and Distant Desktop, in addition to Open Dental. 

One of many issues that has been a terrific profit is that HBNS focuses on minimizing the time supplier employees is offline, Fuchs added. HBNS accomplished the ultimate migration to the cloud over an extended vacation weekend. As soon as the migration to the cloud happened, the operational IT points improved vastly, she mentioned.

Fourth got here COVID-19, distant employees and telehealth. Virtually in a single day, when COVID-19 struck, the supplier wanted to transition its care-delivery mannequin to telehealth and create a distant work atmosphere for employees.

“Proper earlier than we moved to distant working, HBNS had already examined another distant desktop atmosphere utilizing Microsoft Distant Desktop licensing,” Fuchs mentioned. “We expanded that take a look at atmosphere over a few days to make this accessible to all of our employees. This switch couldn’t have occurred so shortly or simply if we hadn’t made the choice, and preliminary setup, to work in a cloud atmosphere.”

Telehealth has been a tremendous shift within the group’s healthcare supply mannequin, she added.

“Sure, many healthcare points want an in-person go to. Nevertheless, lots will be dealt with over a telephone or video name,” she mentioned. “Telehealth is an unimaginable profit to our sufferers, particularly for people who find themselves working, have children at dwelling, are disabled or are struggling financially. It has dramatically improved entry to care.”

RESULTS

“Along with all the aforementioned advantages, on a private degree HBNS has taken an enormous headache and burden off my shoulders,” CEO Fuchs famous. “Knock on wooden, it has been fairly quiet for the final a number of months by way of IT points. Now we’re methods to make use of extra distant know-how and combine our medical and dental EHRs.”

ADVICE FOR OTHERS

“Entry to care wherever/anytime the place suppliers can work from any location goes to be a vital a part of care supply sooner or later,” Fuchs said. “The previous brick-and-mortar strategy to healthcare is not efficient as the one method to supply high-quality care. As leaders in healthcare, we have to be pondering forward about our enterprise fashions, our danger mitigation and, above all, well being fairness.”

As a federally certified well being heart, Santa Rosa Group Well being’s mission is to take care of individuals who typically expertise enormous well being disparities, together with entry to care. Know-how is among the instruments in a supplier’s toolbox to beat these disparities to make sure that everybody has a chance for a full and wholesome life, Fuchs mentioned.

“There are pure disasters taking place yearly throughout the nation and the world,” she mentioned. “In case your telephones go down and your IT is not working, it creates a crucial well being danger to sufferers and the neighborhood. IT is not only a back-office operate – it is among the most crucial components of the healthcare crew.”

With the best IT vendor, the ability of the cloud and a secure IT atmosphere, a supplier group can have higher workflows, the flexibleness so as to add websites and supply telehealth, higher entry to affected person information, and operational studies, she mentioned.

“Whenever you spend money on extra secure, sturdy IT, you possibly can shortly shift your focus to deal with probably the most urgent wants of your sufferers and communities, like offering COVID-19 vaccinations and telehealth,” she concluded. “In the end, making a extra simply and equitable healthcare system for all.”

Twitter: @SiwickiHealthIT
E-mail the author: [email protected]
Healthcare IT Information is a HIMSS Media publication.

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