HCA Healthcare shares five innovations in healthcare technology for COVID-19 and beyond

HCA Healthcare colleagues were recently honored by the Greater Nashville Technology Council (NTC) during the 12^th Annual NTC Awards event for their leadership and innovation in healthcare technology. NTC is a collaborative community and leading advocate for the 60,000 technology professionals who design, implement, manage, and safeguard the technology that powers HCA Healthcare’s hometown of Nashville, Tennessee.

The NTC Awards celebrate the best and brightest developers and technology entrepreneurs, enthusiasts in the region. We’re extremely proud of Dr. Edmund Jackson, chief data officer at HCA Healthcare, for being named Data Scientist of the Year at the awards.

Several talented colleagues also earned finalist designations for the following award categories:

• CIO of the Year finalist: Ryan Dorr, chief information officer (CIO) of Physician Services Group (PSG)
• Infrastructure Engineer of the Year finalist: Marc Smith, consulting technical innovations automation engineer in Information Technology Group (ITG)
• Technology Team of the Year finalist: Network Services team led by Tim O’Brien, assistant vice president of network services in ITG

Congratulations to all of the finalists! These colleagues and their teams were instrumental in developing technology solutions to help HCA Healthcare respond to the COVID-19 pandemic, from enabling remote work and telehealth to developing real-time clinical operations dashboards and a COVID-19 vaccine tracking tool. These innovations not only supported care teams and colleagues during the COVID-19 pandemic but continue to shape healthcare delivery of the future.

“Technologists in our organization view themselves as healthcare professionals first and technologists second. They are the best in the industry, and they not only help advance the expertise of healthcare technology in Middle Tennessee, but their innovations are making a difference in the healthcare industry across the country,” explains Marty Paslick, senior vice president and chief information officer at HCA Healthcare.

Read on to learn about five big advancements in healthcare tech during the pandemic:

1. Equipping a remote workforce

Tim O’Brien, assistant vice president of network services, and his team successfully enabled thousands of HCA Healthcare colleagues to begin suddenly working from home rather than in the office at the onset of the COVID-19 pandemic.

The team had to upgrade hardware quickly so the network infrastructure could handle the rapid increase in usage. They re-designed a remote access VPN solution, deployed new firewall architectures, and activated an additional data center to support remote connectivity.

“There was a lot to do in a very short amount of time. I am so proud of the team and how everyone pitched in. We deployed telephony solutions so colleagues could make and receive phone calls from home offices. Communication had to be reliable,” explains Tim O’Brien.

“Perhaps one of the most significant hurdles was getting wireless devices to colleagues working from home, because we had a disruption with a supplier. With a can-do attitude, the team found another way to accomplish the task at hand,” Tim shares.

The team created a socially distanced assembly line to build work from home kits in an HCA Healthcare office. In less than three days, the team packaged 1,935 wireless devices, 1,935 switches, and 5,850 cables into individual kits and shipped them to colleagues. The packed boxes weighed more than five tons — a nod to the magnitude of the logistical and networking achievement of the network services team and the difference their efforts made to support ongoing operations.

The network was scaled successfully to support 40,000 teleworkers (up from a normal day of less than 10,000). What began as an initiative to ensure temporary remote connectivity for part of our 280,000-strong workforce has resulted in colleagues from many disciplines working remotely for a year and counting.

“The network is a lifeline of sorts that keeps things up and running. All of these efforts ensured that HCA Healthcare could keep supporting services needed by nurses, doctors and hospital operators on the frontlines of the COVID-19 pandemic,” explains Tim.

2. Connecting patients, families and providers through telehealth

Ryan Dorr and his team of dedicated technologists provide applications and technology to more than 7,500 HCA Healthcare-affiliated providers who treat patients in ambulatory and urgent care settings.

“It was my honor and also my charge to help the physicians of HCA Healthcare respond to the pandemic and to help our patients navigate their health journey — always keeping their safety, experience and outcomes as our highest priorities,” explains Ryan Dorr. “We turned to telehealth solutions so patients could continue to see their physicians.”

Alongside our key electronic health record and care management technology partners (eClinicalWorks, Epic, Cerner, MEDITECH, and Experity), teams worked tirelessly to integrate multiple platforms and make new telehealth services available in a matter of days.

“We went from providers performing fewer than 100 telehealth visits on a weekly basis across all of PSG to performing close to one million telehealth visits at the close of 2020. In fact, one morning in April 2020, we completed approximately 5,000 telehealth visits — that one morning surpassed the telehealth visits we completed throughout 2019,” Ryan reports.

Facilities began using telehealth, too, and it became a way to overcome some of the barriers introduced by the pandemic. Patients saw their loved ones and shared priceless moments together. Families participated in physician consultations, and care teams performed rounding while adhering to safety protocols.

Technology solutions were developed with incredible focus and implemented at a pace that became known as “COVID speed.” Although 500 telehealth carts were being used by hospitals, they needed more telehealth devices. Within a few weeks, approximately 3,000 iPads and installed software were distributed so ICU patients and care teams could communicate with family and friends.

“We developed technology solutions for handling surges for COVID-19 testing at our urgent care centers as they became overwhelmed by the number of patients seeking care. Some were experiencing two or three times the usual patient volume for several months. We wanted to help patients, providers and staff continue to have the best experience possible,” recalls Ryan.

The telehealth solutions for urgent care were transformed in a week. Working with a vendor over one weekend resulted in providing care to the first telehealth patient by the following weekend. Technology for telehealth went from an experimental model with one clinic that was supporting another clinic during a COVID-19 surge to delivering full-blown telehealth visits at urgent care locations. Today, patients can schedule virtual visits from websites across HCA Healthcare, including CareNow.

“We continue to see telehealth representing roughly 8% of our ambulatory business and believe telehealth is here to stay. Patients and providers have become more accustomed to the fact that excellent care can be delivered remotely. A paradigm shift has happened in healthcare and I am honored to have been a part of it,” shares Ryan.In case you missed it: Dr. Jonathan Perlin, president, clinical operations and chief medical officer at HCA Healthcare, sat down with Dr. Christopher Ott, chief medical officer of HCA Healthcare’s Physician’s Services Group (PSG) to discuss how physicians embraced the exponential expansion of telehealth at the onset of COVID-19. (Watch the discussion on YouTube).

“PSG is a growing service line with ample opportunities to work on solutions for ambulatory and urgent care settings as well as hospital-based providers, Graduate Medical Education, physician employment, lab services and managed service organizations. Innovation and collaboration are part of the fabric of our culture and how we work, and we work together to complement in-house development with off-the-shelf technology,” Ryan explains.

3. Building a data analytics platform that provides actionable insights to caregivers

For several years, our data science and technology experts have been working in lock step to construct a data analytics platform that can comb through vast amounts of data and provide real-time, actionable insights to a variety of colleagues across HCA Healthcare.

Dr. Edmund Jackson, our chief data officer leads data and analytics at HCA Healthcare.  Dr. Jackson’s Data Scientist of the Year achievement signifies industry recognition for his innovative work and leadership to advance the use of data analytics in the healthcare industry.

One of the first enterprise predictive analytics tools developed by HCA Healthcare teams was SPOT (Sepsis Prediction and Optimization of Therapy). SPOT is an algorithm-based alerting system for the early detection of sepsis and has reduced sepsis mortality across 160 hospitals by almost 30%.

“Our teams spent two years expanding the SPOT technology into a platform to enable a broader set of applications to be created. This platform, NATE (Next-gen Analytics for Treatment and Efficiency), matured just as COVID-19 struck, and we were very fortunate to have it so we could support our leaders and clinicians with the many, many scaled tools they suddenly needed,” Dr. Jackson explains. “If ever the power of platforms was made real – this was it.”

NATE gives a very flexible, holistic visualization of a hospital, integrating real-time facts and predictive analytics so that clinicians and facility operators at-a-glance have a clearer understanding of what’s happening in the facility now and what’s likely to happen in the future. During the pandemic last year, users of NATE grew from hundreds to tens of thousands in just weeks, and today, approximately 70,000 colleagues have access to NATE.

Dan Chisari, the seasoned infrastructure and automation engineer primarily responsible for the technical infrastructure beneath SPOT and NATE, added, “NATE is such a flexible thing that we had to go to the next level of infrastructure to make it real. We embraced SRE (Site Reliability Engineering) from the very beginning and built an OpenShift cluster that runs everything. It’s been incredible.”

Marc Smith, one of the first infrastructure engineers to work on SPOT, described the collaboration between infrastructure and development as a “turning point for infrastructure at HCA Healthcare,” and one that has influenced many other infrastructure projects at the organization.

“Being involved with work to support platforms like SPOT and NATE has been a highlight of my career,” Marc explains. “Our multi-disciplinary teams worked together like never before to develop tools that were mission critical during COVID-19, to support not only our patients but society at large.”

With scalable infrastructure in place, our data science and development teams were able to develop and deploy new tools rapidly — sometimes providing COVID-19 specific applications and algorithms in hours or days that previously would have taken months. For example, two COVID-19 specific overlays were created for NATE and provided real-time data analytics:

• coroNATE: Organized intelligence around COVID-19 patients for every bed in the HCA Healthcare system, which helped us move clinical resources where they were needed most.
• C-ARDS (COVID ARDS): Decision support for clinicians regarding the appropriate clinical protocol for mechanically ventilated patients, specifically COVID-19 patients. C-ARDS gave care team members such as respiratory therapists, intensivists, and nurses the ability to monitor closely key data points for COVID-19 patients, which resulted in decreasing their length of stay and helping to increase survival for COVID-19 in our facilities by 28%.

4. Partnering with others to advance healthcare nationwide

Predictive analytics are invaluable for understanding and meeting the overall healthcare needs of a community, and we were pleased to lead the way in several data sharing efforts with key partners.

“In the early days of the COVID-19 pandemic, our data analytics tools helped us gain confidence and early insights, which enabled us to react efficiently and well. It was incredibly difficult to understand the true picture of the public healthcare need so we approached Google Cloud and SADA Systems about a partnership,” Dr. Jackson explains.

What resulted from the partnership was the COVID-19 National Response Portal (NRP) which allows healthcare providers to securely share anonymous numbers pertaining to ICU bed and ventilator supply and use, test results and total visits to U.S. hospital systems. Also, we collaborated with Google on an impartial, data-based platform offering projection models to help detect resurgences early and to manage reopening efforts.

In Florida, a partnership with GE that began in 2019 with the opening of the GE Clinical Command Center in the East Florida Division expanded across the East Florida, West Florida, North Florida and South Atlantic Divisions as COVID-19 became a reality. The GE Clinical Command Center, a NASA-style artificial intelligence powered hub that uses real-time data to review processes and to enhance communication, became an important mechanism for providing support to frontline care teams and for helping operators anticipate, detect and mitigate risk.

We developed more than 500 new integrations to expand the use of the GE Clinical Command Center and thanks to GE’s effort with local officials, arrangements were made to track certain information state-wide. By combining our GE Clinical Command Center data with state data, leadership in the state of Florida was able to track approximately 18,000 beds in near real time, updated every five minutes, and to observe indicators of local surges. In late September 2020, 80 of more than 300 facilities in Florida were participating, including all of the Florida hospitals in the HCA Healthcare family.

5. Enabling the distribution of the COVID-19 vaccine

As COVID-19 vaccines became available in December 2020, experts in technology, data, human resources and several other disciplines came together to work at “COVID speed” to build the COVID-19 Vaccine Tracking Tool in only 60 days. This tracking tool helps ensure the safety of colleagues and facilitates the vaccination process from beginning to end.

“I have seen first-hand what dedication to our mission looks like. I lost count of the number of times colleagues told me, ‘This is my moment. I joined this company to be part of healthcare and it’s up to me to make something happen.’ I was humbled by our teams, amazed by their creativity in tackling challenges, and we built a vaccination tool in a timeframe that is unheard of. A tool that no one else could build. And, we are grateful we could help,” shares Marty Paslick.

And, as of mid-April, 2021, HCA Healthcare has administered more than 500,000 first and second doses of the COVID-19 vaccine across our organization and in communities we serve to help speed the pandemic’s end and further protect caregivers.

Kevin Drake, assistant vice president of care management, led the development project for the COVID-19 Vaccine Tracking Tool. “This was a colossal effort. We had to build an integrated suite to fit the complex needs of the organization with many unknowns about the vaccine and variation across state lines,” Kevin Drake explains.

The tool follows an individual through the vaccination process, from first notifying participants of their vaccine eligibility to tracking the participant’s decision, scheduling an appointment, documenting vaccine administration and providing data for performance and regulatory reporting.

Building the tool was a collaborative effort, and it had to be in order to get the job done. For example, the scheduling module was born out of work developed by the Central and West Texas Division development team who saw the need to be able to schedule clinic appointments, so they built that feature and it was integrated with the other modules.

“Deployment time was an all hands on deck moment. We launched the tool late one night with the Capital Division. Everyone was on the phone when they released their first tier of vaccination candidates,” recalls Kevin.

“The rapid pace combined with the new and constantly changing technology was extremely challenging to say the least. The team started working all night and through the weekends to support those running clinics and also supporting virtual implementations of new clinics that were just beginning to open,” Kevin explains.

Colleagues from around the company signed up to volunteer and to help run vaccination clinics. At the peak of administering the COVID-19 vaccine, we were operating more than 120 clinic locations.

“We have nurses who work in ITG, and they were helping out in the clinics. Some were called in at the last minute. I had the privilege to walk through the TriStar clinic on opening night and it was like you could feel the relief and enthusiasm. People getting the vaccine were sharing what they were looking forward to and the list brought tears to my eyes — hugs, high fives, not being afraid, live music, time with family,” Kevin recalls.

“Meanwhile, questions and support calls were pouring in. It was in this moment that I became more motivated than ever to help however I could to stabilize the technology. We talk about caring for the community, but for me, there’s no better example than this of caring for your community,” concludes Kevin.

At a glance: COVID-19 Vaccine Tracking Tool

• 120+ clinic locations: Helped streamline the vaccination process for HCA Healthcare colleagues as well as first responders and teachers in communities we serve
• 50,000 physicians vaccinated
• 50,000 direct care nurses vaccinated
• 180,000 total colleagues vaccinated
• 250,000 total vaccinations (HCA Healthcare and individuals in the community)

* Statistics as of 3/26/2021