Jefferson Health’s vision is to continually improve its quality of patient care through innovation. Most recently, that means adopting a digital foundation for telehealth and cloud computing technologies. The 160-year-old, $5 billion healthcare organization in the heart of Philadelphia has set ambitious objectives to digitally transform its operations while maintaining robust cybersecurity. The goal is to become “Jefferson Without an Address,” a way to proactively provide healthcare anywhere to everyone.
“We see the future of healthcare as a continuum with the patient at the center. Wherever the consumer is, Jefferson will be there,” saysNassar Nizami, CIO, Thomas Jefferson University and Jefferson Health, which operates 14 hospitals and employs more than 35,000 people.
A history of innovation
A decade ago, Jefferson began its transformation to digital care. It adopted integrated electronic health records, moving from separate, siloed systems to unified ones, powered by Epic and VMware. Jefferson also saw that patients wanted to be actively involved in their own care. It set up a patient portal—and then created cloud-based mobile apps for patients to access healthcare from wherever they happened to be.
More recently, Jefferson invested in sensors and wearable technologies to enable patients to track health stats and send data via the cloud to its physicians. All the data is then leveraged for the good of everyone, says Nizami. “The more data points we have as a healthcare system, the better we can predict outcomes for patients across the spectrum of care,” he says.
Even for Jefferson, a hospital making steady digital progress, COVID-19 changed everything—accelerating IT when the virus hit. But Jefferson was ready.
COVID-19 drove decade-long planned innovation forward in months
“Like everyone else, we had to make immediate adjustments,” says Nizami. “No one had prepared for a pandemic of this scale.” COVID-19 drove four changes in particular for Jefferson that because of the organization’s investment in VMware technologies will almost certainly become permanent practices at Jefferson:
- Telehealth — Prior to COVID-19, telehealth visits accounted for less than 1% of Jefferson’s activities. That rose to 80% at the height of the first wave of the virus. Nizami estimates COVID-19 accelerated the move to telehealth by as much as a decade.
- Remote work – Overnight, Jefferson had to move several thousand of its back-office employees to home work, and then on the academic side, some clinical groups as well. No one is in a hurry to move back.
- Pop-up clinics – Soon after the pandemic arrived in the U.S., Jefferson opened 15 remote testing sites as well as expanded other clinical venues of care to take care of COVID-19 patients. It now feels prepared to stage specialist “satellite” care centers should another emergency arise.
- Online learning – Thomas Jefferson University—including the medical school—opened for in-person classes in September 2020. But more than half of students have chosen to take virtual classes, a portend of the future.
Fully committed to community health, Jefferson’s remote testing sites are located around the city. “Typically, they are in suburban areas, but we partnered with Dr. Morgan Hutchinson and set up two COVID testing sites in North Philadelphia in an area of underserved populations,” says Nizami.
However, none of it was easy. In particular, the shift to telehealth during COVID-19 was “out of desperation,” says Nizami. “The good news is that we had the technology to provide data services, and we now know the technology works,” he says. But there are still pure technology issues, specifically in the “last mile” of delivering care.
COVID-19 put a spotlight on the disparity between socio-economic groups across geographies, particularly rural and low-income urban areas where telecom infrastructure is lacking. Although 5G mobile networks might accelerate progress in this area, “We have a long way to go,” says Nizami, who says Jefferson is making connectivity an essential part of its community outreach initiatives.
Moving to cloud to battle cyberattacks
In most cases, the journey forward involves the cloud in some way. “We absolutely believe that cloud is our future,” says Nizami.
And cloud inevitably means multicloud. Currently adopting one cloud, Jefferson has a large VMware presence that gives it the ability to move very quickly to any cloud. “We’re building the foundation with the idea that we can shift workloads to whatever cloud provider is most appropriate for each workload,” says Thomas Balcavage, senior vice president and chief technology officer for both Thomas Jefferson University and Jefferson Health.
There are a lot of reasons to move to the cloud, says Balcavage. But with all the recent cybersecurity incidents, security has become the No. 1 reason.
In particular, ransomware attacks are specifically targeting U.S. healthcare organizations.
“It’s a significant threat, and even more than the monetary impact, the operational impact is devastating. This is truly a threat to patient care and patient lives,” says Nizami.
Most healthcare systems have downtime plans for perhaps four hours, or at most, eight hours. But unfortunately, with ransomware, healthcare organizations have to plan for weeks of downtime—to working without the aid of digital technologies, communications, clinical systems, patient records, the works. How do they prepare for this? “Certainly, a key part of our cybersecurity future is going to be migrating off-premises to a centralized virtual environment—in short, to the cloud,” says Balcavage.
The bright, digital future of Jefferson healthcare
Over the next 10 years, technologies such as artificial intelligence (AI), robotics, and 3D printing will continue to transform healthcare going forward. Jefferson is prepared.
Jefferson is exploring AI in a number of clinical settings, such as using predictive models to determine the chances of a patient contracting sepsis when in the hospital, or the odds of re-admissions for a patient based on his or her risk profile.
To help people take more proactive care of their health, the organization is building a Jefferson Specialty Care Pavilion using emerging telehealth technologies such as digital wayfinding, virtual surgical theaters, wearable data, augmented and virtual reality, robotics, and more.
It is scheduled to open in 2024. And because technology will undoubtably change by then, Jefferson is designing a modular infrastructure so that it can remain at the cutting edge.
Jefferson’s leaders are sensitive to the fact that people are frequently interacting with care providers at the most trying times in their lives, and its Jefferson IT’s job to make it as easy as possible for them while taking excellent care of their medical needs.VMware