Industry Voices—Forced innovation: Lessons learned from a virtual go-live

A doctor holding a table
Despite the potential challenges associated with implementing a massive project remotely, McLaren Health Care determined it was necessary to forge ahead to improve communication between clinical staff. (Sergei Domashenko/Shutterstock)

“We’d better wait.” Those were the words burned in my brain after COVID-19 hit.

A go-live we had in the works for more than four years at McLaren Health Care was suddenly at risk of being postponed indefinitely during the final implementation of a five-phase project.

The final portion was the most involved and included four 200- to 300-bed hospitals in the McLaren system—and it was all about to fall apart.

We had been working with PerfectServe to implement their clinical communication and collaboration (CC&C) platform in five McLaren Health regions throughout Michigan. This platform connects all members of the care team and promotes seamless provider-to-provider contact with secure messaging and voice calling, alert and alarm integration, and dynamic routing that adheres to individual contact preferences and live on-call schedules (among other variables) to deliver messages to the right place.

The technical terms can be hard to digest, so here’s the gist: Efficient communication leads to better patient care. We need tools like this to ensure our physicians and nurses can do their best work.

Implementing a new technology system across a healthcare organization is never easy. Some colleagues are enthusiastic about change, while others can be a bit more skeptical. Any trepidations people felt were certainly exacerbated by the pandemic, to the point that even those excited about the project wondered if we should—or could—continue executing remotely.

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The more we learned about COVID-19, the more it became clear that if the project continued, there would be no on-site interaction between the McLaren and PerfectServe teams. We were in total shutdown mode and would not have the support staff at arm’s reach to help smooth out any wrinkles. Talk about a curveball!

As we started to better understand COVID-19—how transmissible it was, how much isolation it was causing—we realized this CC&C solution was precisely what we needed to facilitate safe, reliable, and effective communication among clinical staff. Despite the potential challenges associated with implementing a project of this magnitude remotely, we determined it was necessary to forge ahead.

I had never been a part of a remote go-live project before, but I have been a long-time proponent of technology in healthcare. Having had the benefit of working with the vendor as an emergency physician at another Michigan-based health system during the Ebola scare in 2014, I knew we were in good hands.

I also knew we couldn’t delay the project or lose momentum.

Going live

After some deliberation, everyone was on board with continuing the project, but now we had to rethink the go-live model. PerfectServe would only be available from a distance.

Many of our internal go-to resources for this project were working from home, furloughed, or on shortened hours. We were fortunate to have a couple of people from McLaren on-site, rounding.

In a matter of days, and with a sense of collective purpose across the two teams, we were able to redesign our launch strategy and begin executing the final phase of implementation across all four hospitals remotely.

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What we learned:

  • A go-live project of this size can absolutely be done virtually, but you need to have a small in-house crew involved and on-site to be facilitators.
  • Keep the project moving: There will always be pushback and resistance to change, so work with a team who can take on (some might say “influence”) difficult providers and push forward.
  • Along those lines, physicians tend to listen to other physicians—make sure you have physicians on the project team who are willing to influence their peers.
  • Make sure your people know exactly how to get help, whether that means creating lots of signage or disseminating other resources internally.
  • Find the right technology partner: Work with a trustworthy vendor who will be available to your project team and staff 24/7, rain or shine.

Hacks that really worked:

  • With input from McLaren and PerfectServe team members, we created detailed FAQs and tip sheets tailored to the unique needs of McLaren users; with little in-person interaction, we made sure the materials incorporated as many McLaren-specific workflows as possible.
  • We held 26 different Zoom sessions to train super-users, who then went on to train their colleagues.
  • The vendor activated a Zoom link for 24 hours a day the entire week of the go-live and provided an on-call consultant for nurses.
  • For the few people on-site, we had continuous rounding to make sure questions and concerns were answered quickly.
  • We arranged it so that anyone could pick up a phone, dial a dedicated four-digit extension, say the word “help,” and immediately connect with a PerfectServe team member.

Success metrics the day of launch:

  • 95% of registered providers had their schedules entered in the new system, which is important since schedules are frequently referenced to route communications
  • Fewer than 10 communication routing errors
  • 227 interactions exchanged (only 100 were expected), with utilization remaining high and increasing as elective procedures began to resume
  • 88% of core providers (credentialed physicians who do the lion’s share of admissions) were registered

By all accounts, this project has been a major success, to the point that metrics from this remote go-live phase have outperformed metrics from several of the prior four phases.

Process changes of this magnitude are never easy, but it’s been particularly rewarding to see healthcare teams at their most resilient and adaptive during a global pandemic when uncertainty is the order of the day.

In the past few months, we have witnessed transformation in healthcare that previously might have taken years, and this experience working closely with a technology vendor to execute a complex project remotely is a prime example.

That’s why, despite the real and tragic effects of COVID-19, I’m firmly convinced that the healthcare system in the United States will emerge from this crisis stronger, more focused, more responsive to patient needs and better prepared for the future.

Norman Chapin, M.D., MBA, serves as chief medical officer for McLaren Health Care’s Bay and Thumb Regions. He was previously the vice president for quality improvement and process improvement at Grand Rapids, Mich.–based Spectrum Health. Prior to that, he worked as an emergency physician in New York.