Latest / Becker’s Healthcare Podcast / How AdventHealth Navigates Workforce, Operations and Care Continuity

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How AdventHealth Navigates Workforce, Operations and Care Continuity · Becker’s Healthcare Podcast

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Hello, everyone. This is Erica Spicer Mason with
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Becker's Healthcare. Thank you so much for tuning
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in to the Becker's Healthcare podcast series.
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Today, we're going to talk about how AdventHealth
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navigates workforce, operations, and care continuity.
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And joining me for this conversation, we have
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Tony DeSantis, the executive director of procedural and
0:20
clinical imaging systems at AdventHealth.
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And we also have Ansley Miller, strategic account
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executive at Insight Global Health. Toni Ansley, so
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glad to have you both on the podcast.
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Thank you so much for being here.
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Thank you. Thank you.
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Well well, before we get into our conversation,
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I'd love to learn just a little bit
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more about you both.
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If you wouldn't mind sharing just a bit
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about your background and your current work in
0:43
health care. Tony, maybe you can get us
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started there. Sure.
0:47
Yeah. So I've worked in health care IT
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for over twenty years in various systems,
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health care systems and application systems
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spanning various
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areas of care. Right now, my role is
1:00
executive director of procedural and clinical imaging systems
1:03
at AdventHealth.
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I have,
1:05
responsibility
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for our procedural applications
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and our,
1:11
clinical imaging applications as well as various third
1:14
parties associated with those care areas.
1:18
Thanks, Tony. And, Ansley, please go ahead.
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Yes. So excited to be here. I'm our
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strategic account executive,
1:24
specifically supporting our partnership with AdventHealth.
1:27
My focus is on delivering staffing, professional services,
1:31
and consulting services,
1:32
to really make sure we are supporting our
1:34
partnership in the most effective way and really
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excited to talk more about that today. So
1:39
thank you guys so much. Oh, great. Well,
1:41
I'm really excited to learn a bit more
1:44
about what's going on at AdventHealth
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and and how, Ansley, to your point, your
1:48
team has supported the health system.
1:51
And I know that through our reporting at
1:52
Becker's, you know, we covered AdventHealth's
1:54
EPIC rollout that was completed just a couple
1:56
of years ago, and we know EPIC implementations
1:59
are very complex. And Lumen's, as part of
2:02
EPIC, is still relatively new territory for a
2:05
lot of health systems.
2:06
So I'd love to learn from both of
2:07
your perspectives,
2:09
what makes these go lives uniquely challenging from
2:12
both the workforce and an operational standpoint.
2:15
Thanks, Erica. So,
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yeah, as you mentioned, we just, a couple
2:19
years ago, completed a multiyear
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epic deployment
2:23
across our entire organization.
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At that point, I think we
2:27
during that phase, that design phase, we entertained
2:30
Lumens as an option, but, we were using
2:32
another system,
2:34
one that's been around for a long time.
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And,
2:37
we've had we determined at the time that
2:38
it was not the Lumen's was not at
2:40
the right maturity and I and to to
2:42
make that move. And I say that because
2:45
that was a that was a key,
2:47
factor in our ultimate decision.
2:51
So fast forward
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a couple years post
2:56
that decision while we were
2:58
still winding down our
3:01
enterprise epic deployment.
3:03
We
3:04
were following the Lumen's development cycle pretty closely.
3:07
And I think it was in 2023
3:10
that we
3:12
determined that Lumen's was probably at the right
3:14
stage of maturity where we could make it
3:16
work.
3:17
I think it was
3:19
going to be,
3:21
an uphill
3:22
challenge
3:23
to
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replace a long standing
3:27
trusted system
3:30
with something to your point that's very new.
3:33
I think we had seen a few
3:35
examples out in the market
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where large
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systems had deployed,
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Lumens,
3:43
and we had heard some positive feedback through
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that of the efficiencies that were gained.
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So we structured our project in a way
3:51
that allowed a significant amount of time for
3:56
design
3:57
and development
3:59
as well as
4:00
awareness.
4:02
And so we we put a lot of
4:04
effort into ensuring that it was a clinically
4:07
driven project. We had endoscopy
4:09
experts from our system
4:12
that were
4:14
part of a core design group that then
4:18
they
4:20
shared
4:21
design recommendations with the larger
4:24
endoscopy community
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within AdventHealth.
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So it was really led and championed by
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our clinicians,
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and I think that was a key factor.
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Additionally, once we were
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at the point where
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we
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had a had a functional design, we did
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a lot we got out to the sites.
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We did in partnership with our our chief
4:47
medical information officer
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champion and,
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our teams are in within our design teams
4:54
within AIT.
4:56
We
4:57
went out to every site and did
5:01
roadshows on what was changing, what it was
5:03
gonna look like, what the workflows were gonna
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be.
5:06
And I think that really helped,
5:08
bridge it helped create awareness for sure. It
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helped,
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a lot of people ask questions, and it
5:15
started to build the foundation
5:18
of what we would do in the second
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year
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of the project, which was start to actually
5:23
deploy across our sites.
5:25
Tony, I appreciate the overview.
5:27
It's interesting what you're saying here about
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acknowledging that, you know,
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I guess, big system switches or just introducing
5:35
new tools. It can be an uphill challenge,
5:37
especially when replacing a trusted system. But it
5:39
sounds like that clinician first approach that you
5:42
took with the endoscopy experts and kind of
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relaying that that knowledge and those insights across
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the teams at at AdventHealth went a long
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way.
5:50
And, Ansley, I'd love to hear from your
5:52
perspective too what you observed here.
5:54
Yeah. You know, I think everything Tony just
5:56
mentioned was really important for us to take
5:58
into account when we jumped in later on
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from an implementation standpoint for support. Right? Clinician
6:05
focused, how are we
6:06
taking in all of that preplanning that was
6:08
done to ensure that we were not just
6:11
partnering from a staff augmentation model only, but
6:14
for something more. Right? Something that would provide
6:17
more value.
6:18
But when we're thinking about a challenge and,
6:20
you know, really where we come in is
6:21
from more of a workforce or operational standpoint,
6:24
Where we see challenges in this area is
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more from, you know, a scale perspective.
6:29
You know, these are often one shot implementations,
6:31
so, you know, you really have to get
6:33
it right. And from a workforce standpoint, it's
6:35
all about people management and alignment. And I
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know that was a big piece for our
6:39
team and Tony's team to make sure that
6:41
we had the right partnership in place, and
6:43
we were collaborating
6:44
on what the right support model would look
6:46
like when they were deciding to put this
6:48
into implementation mode.
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And, you know, productivity was a big thing.
6:53
And what Tony mentioned before, making sure that
6:55
the clinicians felt confident in using the system
6:58
and that we provided resources that would support
7:00
in that. So that was a big focus
7:02
for us as well.
7:04
So such a helpful perspective, Ansley. Thank you.
7:07
And it leads me nicely into what I
7:09
wanted to ask about next.
7:11
Tony, I know that you've moved away from
7:14
a traditional staff augmentation model towards something that's
7:17
more integrated and collaborative.
7:19
So I'd love to learn more about what
7:21
prompted that shift and the challenges that you
7:23
were aiming to solve in making that change.
7:26
Sure. As we looked at scoping out the
7:28
project, again, we were deploying
7:31
across
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56 hospitals
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and, you know, a number
7:36
of specific labs, GI labs that we're
7:40
gonna deploy. So
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and and Ansley covered this a little bit.
7:43
Like, the scale of it was massive.
7:47
So we started
7:48
small, and our model was we shifted. We
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were trying to look at how do we
7:53
how do we do these big enterprise
7:55
implementations,
7:57
in a more cost effective manner. How do
7:58
we how do how are we,
8:00
you know, faster to market? How are we
8:02
more effective in our support, like, in
8:05
in doing this all, you know,
8:08
budget conscious?
8:09
So we started in a smaller market,
8:12
and we went live with four hospitals. And
8:15
we we supported that
8:17
internally with our in in heavy partnership with
8:20
our informatics team. And
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as we did that, that model really worked.
8:25
So what we
8:27
tried to capitalize on was as we
8:29
continue to move to bigger and bigger implementations,
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we
8:34
ran into well, we we only have so
8:36
many internal resources. Right? It's going really well.
8:39
The people that know the facilities, know the
8:41
workflows, know the people are out there supporting
8:44
the people.
8:45
And
8:46
but we don't have enough of those people
8:49
to cover everybody. And we all knew, like,
8:51
the the, you know, the design could be
8:53
perfect, and the you could do all the
8:56
change management in the world. If the support's
8:57
not there during the go live, it's gonna
8:59
sink or swim kind of on that because
9:01
people are gonna be left with, did I
9:02
get the help I needed, or did I
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not get the help I needed when I
9:05
needed help?
9:07
So we looked to how do we take
9:09
the model that we that has been working
9:14
and augment
9:15
where we had gaps. And so we kind
9:17
of took a an approach of
9:21
filling in, like, leaning on our internal people
9:24
and filling in
9:27
at those facilities where we had a partnership
9:29
of
9:31
AdventHealth Informatics
9:33
and Insight Global
9:35
working together
9:36
so that they could capitalize on the knowledge
9:39
that the informatics individuals had and still
9:43
offer the support to
9:45
whoever needed it wherever. Or, you know, we
9:47
we wanted one of our goals and our
9:49
guiding principles
9:50
for the project was if I turn if
9:53
I turn around, I needed to have somebody
9:53
right there with me. I didn't wanna turn
9:54
around and find no one if I needed
9:55
help because we wanted we wanted the support
9:57
to be on the spot. And so I
10:00
think
10:01
that model,
10:03
there was a lot of factors that factored
10:05
into shifting that model. Right?
10:07
And
10:08
I think it really
10:09
I think in the end, it really, really
10:11
worked because you had you had people coming
10:14
in, and it's hard. And and we took
10:15
an approach of we trained the people, the
10:18
the the from Insight Global. We held training
10:20
sessions so they can understand this is what
10:21
we're doing. This is how the model this
10:23
is how we supported it. This is how
10:25
we've designed it.
10:26
This is what we're not doing
10:28
in case because, you know, people do things
10:30
differently at different organizations.
10:32
We wanted peep we wanted them to feel
10:34
like they knew the AdventHealth way. So and
10:36
then we partnered them with our local informatics
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people. And so I don't think
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we had
10:43
one area or one location
10:45
where there wasn't a partnership group
10:47
between Insight Global and AdventHealth IT informatics
10:51
on-site, and I think that model worked really
10:53
well.
10:55
Mhmm. Collaboration and strong partnership are definitely the
10:58
terms that that come to mind as you're
11:00
describing that, Tony, and appreciate you sharing that
11:03
guiding principle too that you had at AdventHealth
11:05
wanting to have someone there at every turn.
11:09
So appreciate you touching a bit more too
11:11
on the Insight Global partnership.
11:13
Can you say a little
11:14
bit about why you chose Insight Global as
11:16
the partner of choice?
11:18
Yeah. So, again, scale. Right? So when we
11:22
when we partnered with Insight Global, it was
11:24
our largest by far go to live. I
11:26
think we had 40 plus locations that we
11:29
were gonna be supporting,
11:31
in that go live. And
11:33
we knew
11:35
things happen, right, as as you go live.
11:38
You know, I tell my team all the
11:39
time, like, the plan is the the plan
11:41
is just as is good up until go
11:43
live, and then everything changes.
11:45
So
11:47
Insight Global
11:48
offered
11:49
services. They offered a whole team of people
11:51
to help coordinate the resources.
11:54
And
11:55
that for us was a differentiator
11:58
because
11:59
the value that that presented to us in
12:02
a go live of this,
12:05
criticality
12:06
where change management was huge,
12:09
and
12:10
we knew that we wanted the support to
12:12
be top notch. You know, if somebody had
12:14
a flight delay or some anything,
12:17
we needed one point of contact
12:19
to
12:20
help pivot that.
12:21
And and, you know, also, Evan Health's a
12:23
big place. There's a lot of different locations.
12:25
Right? If somebody got
12:27
need you know, if we had a slowdown
12:29
at one place, but a but a pickup
12:31
at another place, we wanted the nimbleness to
12:33
be able to pivot those people.
12:35
And for my team and my leaders to
12:37
have to worry about that,
12:39
would have pulled them away from focusing on
12:42
the go live overall.
12:45
So the ad or Insight Global
12:48
provided a whole team that we could dialogue
12:51
with, and we were all in kind of
12:52
a a a Teams chat together
12:55
that if we had a need, if we
12:56
were getting a need reported, we just pinged
12:58
them, and they were immediately on it. So,
13:01
I mean, that for us was invaluable, and
13:03
it provided us it it enabled us to
13:05
be more nimble than I think we had
13:08
been in previous go lives
13:11
where we had,
13:12
staff augmentation present.
13:15
And
13:15
so I think I I think the model,
13:18
I guess, if I
13:20
all things lined up. Right? We had
13:23
local
13:25
AIT
13:26
informatics
13:27
support
13:28
working with the Insight Global team. So we
13:30
had
13:31
we had multiple lines of escalation, both internal
13:34
through through our informatics people, through us in
13:38
the project leadership side, but we also
13:41
the Insight Global team that were frontline had
13:44
an escalation path through that
13:46
coordination team
13:47
that got back to us as well.
13:50
And so
13:51
not only did it help with coordinating the
13:53
resources, it helped with the communication.
13:55
So we all knew what was going on
13:57
all the time, and we had that bidirectional
13:58
communication
13:59
that really enabled us to be really super
14:02
nimble with the support. And I think
14:04
when we made the selection, that was the
14:06
differentiator,
14:07
and it proved in the go like, throughout
14:09
the go live, it proved to be the
14:11
value that we anticipated it to be. If
14:13
I can say one thing on the Erica,
14:14
because, Tonya, I just appreciate you giving such
14:17
insight into that and, you know, this partnership
14:19
has been awesome. But at the same time,
14:21
right, we wanted to be very high touch
14:23
with you all, and our role was really
14:24
to take that operational burden off of AdventHealth
14:27
and off of Tony's team so they could
14:29
really focus on the go live itself. Right?
14:31
That is what being a good partner was,
14:33
and that was our goal from the beginning.
14:35
You know, making sure that we had the
14:36
right people in the right place, that we
14:38
were coordinating flights across The United States, and
14:40
we were making sure schedules were right. We
14:42
were taking on that burden so that there
14:44
was strong day to day management and that
14:46
this would go well. And as we mentioned
14:48
before, we wanted to think of the clinicians
14:50
and the physicians and the end users so
14:52
that it was executed in the right way.
14:54
So that was our our guiding light through
14:56
a lot of this. Yeah.
14:58
And and and you guys you guys absolutely
15:00
lived up to that. I'll I'll even say
15:02
that to the point. You know, we had,
15:04
I mean, I had a real life example
15:06
where one of our informatics leaders sent me
15:08
a text. I think it was, like, eight
15:09
or 09:00. I threw something into the chat,
15:11
and one of the Insight Global people were,
15:13
like, on it. And it I think the
15:15
the whole thing was resolved in a within
15:17
a couple minutes. That's awesome. So it was
15:20
like if that that
15:22
really was amazing for us.
15:25
Such a high degree of collaboration as I
15:27
mentioned earlier, and that just comes through in
15:29
both of the the insights that you've shared.
15:32
And I know something else that both of
15:34
you have touched on at one point or
15:35
another too is just the sheer complexity
15:38
involved
15:39
in in making a go live go well
15:41
and and successfully.
15:43
And one aspect that can get overlooked in
15:46
these transitions
15:47
is what happens to clinical operations
15:50
while IT is in flux. So I'd love
15:52
to know how you approached
15:54
maintaining care continuity, Tony, during the Lumen's rollout,
15:57
and what structures or guardrails did you put
15:59
in place to make sure things stayed on
16:01
track?
16:02
Yeah.
16:04
So we I'll go back to the in
16:07
year one of our of our two year
16:09
Lumen's deployment,
16:10
we we did the roadshows. So,
16:13
we had the benefit of our CMIO
16:17
champion also being a GI practicing GI doctor.
16:21
So this was this was very much a
16:23
passion project for her. She loved it. And
16:26
we did they they went to every location
16:29
in that first year, every single location in
16:32
that first year, and they met with the
16:34
they met with the the clinicians. They met
16:36
with the providers and the nurses, everyone that
16:38
was impacted.
16:40
They they they put the time in, and
16:42
they did an overview, and then we did
16:44
shadow charting after with the same level of
16:47
intensity.
16:48
We had our informatics team involved.
16:51
We trained them on the workflows.
16:54
We we we created awareness.
16:56
Like, one of our other goals this was
16:58
this was not an official goal. This was,
17:00
like,
17:01
this was an unofficial goal, I will say,
17:03
of the project, but I didn't want anybody
17:05
on day one saying, I didn't know this
17:06
was happening.
17:08
And we didn't have that. Right? We we
17:09
didn't have that. So
17:11
our our go live was fairly
17:14
seamless.
17:15
And I hesitate to say that because, you
17:17
know, as soon as you say something like
17:18
that, you know, something happens. But,
17:20
our incident count was extremely low,
17:24
for the first couple go lives. I don't
17:25
know I don't know that we had,
17:27
you know, one or if we got it
17:29
and we determined it was not due to
17:31
the go live. So it it was it
17:33
was a very low incident count.
17:36
Everyone understood that it was happening.
17:39
Everyone understood
17:41
what the workflows were. And and I think
17:43
the the the credit of it, like, which
17:46
I'll go back to, the the the things
17:48
that we had heard before making the decision
17:50
to embark on this project was that the
17:54
the even though the the module was newer,
17:57
it provided
17:58
a tighter integration
18:00
and and more efficiency.
18:02
So I think the clinicians and the providers
18:04
realized that almost immediately
18:07
in terms of transitioning. I mean, yes. There's
18:09
there's request work that we're doing, and people
18:12
have ideas, and and we're processing through that.
18:14
But I think the awareness that we created,
18:16
the commitment to partnering and being in in
18:19
front of the clinicians
18:21
before,
18:22
during, and after the go live around, you
18:25
know, how it's going, what questions do you
18:27
have.
18:28
This is what's changing. That was how we
18:31
kind of
18:33
mitigated
18:34
the the disruption of going live
18:37
with relatively,
18:39
you know,
18:40
no disruption.
18:42
Mhmm.
18:43
Tony, I love what you said too about
18:44
that kind of informal goal about
18:47
not wanting anyone to be surprised by the
18:49
go live and the implementation. I I I
18:51
think that's,
18:52
it shows a lot about the spirit behind,
18:55
kind of your mentality behind this big transition.
18:58
And, Ansley, I'd love to know what,
19:01
you know, considering everything that Tony just shared,
19:03
why is this also crucial from an operational
19:06
perspective?
19:07
Yeah. Absolutely. And, you know, the surprise aspect,
19:10
Tony. There's always a surprise here and there.
19:11
Right? But you gotta you gotta be ready
19:13
for it at any point. But, you know,
19:15
for continuity, you know, our team actually implemented
19:18
a pod based model for this program, which
19:21
was a little bit different and I think
19:23
really was a big player in how we
19:25
were combining the clinical operation side and the
19:27
IT operation side
19:29
together.
19:30
So our focus was on, you know, finding
19:32
SMEs and binding individuals who were clinically fluent,
19:35
who could really speak the language of the
19:37
hospital staff and just provide that extra value.
19:40
So from an operational standpoint, you know, we
19:42
focus heavily on the consistency piece, keeping resources
19:45
in the same locations whenever possible
19:48
so they could really, you know, go to
19:49
the values of AdventHealth and of Insight Global.
19:51
Right? We take care of each other and
19:53
that high touch,
19:55
really learning each other so that this would
19:57
be successful. Right? And we were adding value
19:59
in that way too. I think that was
20:01
a big piece from an operational point of,
20:03
you know, again, the real partnerships to form
20:06
and
20:07
allowing for best practices to flourish so that
20:09
this could go off seamlessly as Tony mentioned
20:11
before.
20:13
Great add on, Ansley. Thank you.
20:15
And I know both of you have already
20:17
acknowledged
20:18
how much you both have valued this partnership
20:20
between AdventHealth and and IGH.
20:23
But if you could distill it down to
20:25
maybe one or two things that
20:27
this partnership,
20:29
between health system, staffing partner,
20:32
what has it taught you? If you could
20:34
sum it up in one or two best
20:36
practices or insights, and how has that changed
20:38
the way that you think about partnerships moving
20:40
forward?
20:42
Yeah.
20:43
So
20:44
I I I think the collaboration and the
20:46
willingness to collaborate, and I say that because,
20:49
you know, in the Insight Global team kind
20:51
of really sat down with us and and
20:55
listened to how we wanted the go live
20:57
to go, what we wanted the end user
20:59
experience to be.
21:01
And, I mean, Angelie just mentioned, like, how
21:03
they they implemented the pod based model here.
21:06
Right?
21:07
So so I think that the the willingness
21:10
to to adjust and to adapt
21:13
to kind of what our strategic goals were,
21:15
I think, is is is,
21:18
you know, underneath if I look at the
21:19
broader category of collaboration, I think that underneath
21:22
the willingness to flex and the willingness to
21:25
innovate how we can do this differently
21:27
and better.
21:28
I know we've taken a lot of lessons
21:30
learned from this project in how we roll
21:32
things out within our own organization, and we're
21:34
we're carrying that forward.
21:37
And I think this is a key that
21:38
that how we how we engage
21:41
with staff augmentation
21:42
is is one of those key elements. Right?
21:44
We, you know, we've we've done it before
21:47
where we've just done pure staff. We haven't
21:50
even had people out.
21:51
And
21:52
I think this
21:54
everyone involved would say this this model has
21:56
gone infinitely better than some of those previous
21:59
ones because it was a partnership, and it
22:02
was a collaboration at all aspects. From the
22:04
frontline, we had both organizations represented with resources
22:07
all the way up to us kind of
22:09
coordinating as a as a leadership team with
22:11
the Insight Global coordination team, allowing us to
22:14
be as nimble as we could be and
22:16
really not having really any gaps in the
22:19
support model.
22:20
So it's it definitely caused us to think
22:22
about how we do things differently and how
22:25
we can be more effective
22:26
in in all aspects. Right? I think this
22:28
provided us a way to be a little
22:30
bit more effective
22:32
for sure operationally,
22:33
but also fiscally. Right?
22:35
I think, you know, as we looked at
22:36
how do we how do we deliver projects
22:39
more
22:40
efficiently in all aspects, I think that was
22:42
a big piece of how why we shifted.
22:44
And Insight Global really supported us in that
22:47
aspect as well.
22:48
Yeah. Well said, Tony. And I think, you
22:50
know, that was a big focus for us
22:51
just going off of the, you know, fiscally
22:54
thought there. You know, we wanted to make
22:56
sure we were supporting with controlling costs and
22:58
how can we support you guys so that
23:00
we create a model in a sense, right,
23:02
for future cases similar to this. And I
23:05
think when we're looking at what this taught
23:06
us too, it just really reinforced what you
23:08
mentioned before,
23:10
how important for, you know, partnerships like this,
23:12
whether it be staff augmentation or something like
23:14
this where it was more of a large
23:16
scale professional service, we
23:18
enacted with you all, but it's all on
23:20
creativity,
23:21
agility,
23:22
and the word of word of the session,
23:24
collaboration.
23:26
You know, I think in moments like this,
23:27
it's success comes from having a partner who
23:30
can adapt quickly,
23:31
who can along think alongside each other,
23:34
and really just take ownership of what those
23:36
outcomes look like and really move on to
23:38
create change from that. And I you know,
23:40
we're very thankful that we were able to
23:42
do this with AdventHealth and with your team.
23:46
Well, Ansley, Tony, it's been such a pleasure
23:48
learning from you both and what really worked
23:50
in this partnership, especially with the health system,
23:53
the size, and the scale of AdventHealth. It's
23:55
very insightful to hear about some of practices
23:58
that really served you all and the clinicians
24:00
well. So I just wanna thank you for
24:03
your time and and for sharing,
24:05
all of your learnings today with Becker's audience.
24:07
Thank you. Thank you. Yep.
24:10
And we'd also like to thank our podcast
24:12
sponsor for today, Insight Global Health.
24:15
Listeners, be sure to tune in to more
24:16
podcasts from Becker's by visiting our podcast page
24:19
at beckershospitalreview.com.