Innovating on the Frontlines of a Pandemic

May 6, 2020

In this episode of One Quick Thing, Roberta Schwartz discusses changes at Houston Methodist hospital during the coronavirus pandemic. Topics of discussion include virtual rounds, testing new technologies, and the challenges of innovating in the healthcare sector.

Schwartz is the Executive Vice President and Chief Innovation Officer at the hospital. As an EVP, she runs the hospital’s academic medical system. In her innovation role, she works on advancing and expanding Houston Methodist’s digital innovation platforms. Below are five takeaways from the conversation.

Virtual Rounds

In more normal times, Schwartz takes pride in making rounds at Houston Methodist, visiting patients and employees in various departments. However, at the start of the pandemic, Schwartz was appointed Incident Commander for the hospital system. In this role, Schwartz had to confine herself to either the incident command center and home to prevent the spread of disease.

To stay connected with patients and teams, Schwartz began to make her usual rounds virtually, with a staff member “transporting her” from station to station using an iPad.

“They started basically wheeling me around to the floor so I could talk to the employees and patients,” she said. “People want to talk about protective equipment. … When we go back to doing scheduled surgery… lots of really good questions.”

Houston Methodist’s “Digital Innovation Obsessed People”

Long before COVID-19, Schwartz assembled a “motley crew” of different people to form the a committee named DIOP — Digital Innovation Obsessed People. According to Schwartz, the team she assembled included an equal number of healthcare staff and operational employees.

“DIOP started talking about how we saw things kind of evolving in our industry, and that we could play a leading role,” she says. Projects tackled by the team include building the infrastructure for telemedicine.

“We were having some cultural problems getting it adopted and ready to go from the physician perspective…but the technology was there. The iPads, [Epic’s] MyChart, bedside, all different types of technologies were embedded,” she says. At the start of the pandemic, “all we had to do was say, ‘There, turn them on.'”

Schwartz says her team trained 600 doctors to use the telemedicine technology set in a two-week period — a number that continues to grow.

The Virtual ICU

During the pandemic, the hospital has been able to work with patients through a virtual ICU. In the virtual ICU, rooms are equipped with cameras that have a 360 degree view of the room. Cameras are powerful enough to zoom in and read the text on IV bags and ventilators. Schwartz says. “We said to [our doctors], how about you go home and sleep at night and we have these doctors from New York go cover you so that you don’t become burned out,” she explained. “All the diagnostics or the changing of medications or other things could be done remotely.”

Links to the room could also be sent to family members of COVID-19 patients. “They could sit with the patient at bedside, even if they weren’t physically there,” Schwartz said. “So we’ve had families who have had to say goodbye to loved ones on a Zoom[-type of] technology, but they’re in the room with the patient.”

The Technology Hub

The Houston Methodist Technology Hub, which opened in February 2020, is located in a converted patient unit. It allows Schwartz’s team to work with new technology that could be implemented in the hospital. This space includes a living room, a hospital room of the future, and a clinic of the future, where technology can be tested.

“There’s no cost [for tech providers] to come into our Tech Hub and play with our clinicians or our tech folks,” she says. “Once we decide that we’re moving something into more of a…pilot phase that we’re really going to try in the clinical environment, we look at things as long-term partners. … We will do a slight trial in a small area, but…we always assume that we’re going to scale something.”

Schwartz says experimentation provides learning, even about technologies that don’t get deployed. “…It may not be that the tech is bad, it just may be that it’s not a cultural fit for our organization or that point in time,” she says.

Taking Care of Care Providers

“COVID is as much mental, as everybody knows, as it is physical. And it’s mental for the families and people who feel like they have Scarlet letters when they get COVID,” Schwartz explains. She also says that the disease can put a mental strain on frontline workers providing care. At Houston Methodist, free telemedicine psychiatric care and social work visits have been made available to caregivers. “You have to deal with the emotional health of the patients, of the visitors, and of your staff.”

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Innovation in Health Care 

InnoLead asked webcast attendees to share what they thought was the biggest inhibitor to innovation in the healthcare sector. Out of 44 respondents, 39 percent said that the insurer/payor bureaucracy was the biggest inhibitor. The second largest group (20 percent) cited regulations.