Prior IT Investments Helped Health Mission Agencies Pivot to Telework

Key Takeaways:

• Prior IT infrastructure investments positioned agencies to be able to pivot to mass telework during the pandemic.
• The workforce and industry partners helped to enable a successful switch to virtual work.  
• Telehealth was a somewhat harder pivot due to culture and, to some degree, technical gaps.

On Tuesday, several IT leaders from health mission agencies participated in panel discussions regarding their agencies’ challenges and successes pivoting to virtual work during the pandemic, as well as efforts to harness technology to improve mission delivery.

As part of the kickoff to AFCEA Bethesda’s Virtual Health IT Summit, with presentations taking place over the entire month of March, HHS CIO Perryn Ashmore said the agency was able to exercise all the investments they’d made in remote technology. Many of the panelists echoed this comment.

Andrea Norris, NIH CIO, said that they had the support infrastructure in place to handle massive telework due to heavy investments made prior to the pandemic.  NIH has made major investments in big data tools and the infrastructure to support them.  This same infrastructure was well prepared to handle mass telework. 

CMS CIO, Rajiv Uppal, stated that his agency has been investing in infrastructure such as cloud, Zoom, and VPN over the last several years. “The pivot wasn’t so much can the infrastructure handle this, but can we all be productive and engaged?” He said, “People stepped up and did what was needed… Barriers from the past seemed to disappear and everyone banded together across HHS.” Uppal said that typically people hesitate to reach out across organizational lines, but the pandemic made everyone more comfortable reaching out and has to new relationships.

In a later panel discussion, Stacie Alboum, Deputy Director for the Center for Information Technology (CIT) at NIH, said, “The key to success in this entire experience has been the people factor.”  She stated that it’s one thing to have the tools and technology in place, which they did, ”but embracing them and knowing how to make the most of them is a whole other matter.”

Panelists also credited industry partners and vendors for their speed and agility in providing support and products to their agency clients. Kevin Duvall, Acting CDO at HHS, said that industry partners were invaluable and went the extra mile. He also credited the FEDRAMP program, because it gave them a trusted resource and set of vetted partners and products with embedded controls. 

All the panelists admitted that they faced challenges during the pandemic.  Two different panelists said that the pivot to telehealth was culturally challenging. Dominic Cussatt, VA CIO, said that VA already had a telehealth presence, but it had not been widely adopted. Clinicians and veterans were apprehensive about virtual healthcare visits, but the pandemic forced patients and doctors to try it. Now they incur 45,000 telehealth visits per day. People are having good encounters and clinicians can see many more patients according to Cussatt. VA is looking to the future and how it can sustain this “force-multiplying capability” said Cussatt. 

For the Defense Health Agency (DHA), virtual health was “the biggest deal,” according to Military Health Systems’ CIO, Pat Flanders. “It is not just enough to be able to see the patient with video.  The visit must be integrated with patient records and scheduling,“ said Flanders. They now have two formal programs, that are both being developed and fielded by the Program Executive Office (PEO) for their new health record system.

Another challenge faced by agencies involved workforce training. Uppal said that its not just the tools, but how to engage using the tools.  CMS gave people training on how to use the tools and make them part of their work environment. Cory Milam, Director, Office of Innovation at FDA, echoed those sentiments. “We were used to telework, but the training on new tools was more difficult.”  Alboum from NIH concurred. She said that it caught their agency by surprise to some degree, but they quickly ramp up training and IT support for staff.  

Participants in both panel discussions agreed that the future work environment will likely be a hybrid program that includes telework, people in the office, and permanently remote workers.  Their teams are trying to assess what the future should look like in terms of infrastructure, tools, and services to support this future scenario.