NYC Health + Hospitals

EITS Vision:
Revolutionizing the patient experience through innovation and technology.

EITS Mission:
Providing exceptional IT Services to support high-quality health care outcomes for our community.
Enterprise IT Services (EITS) is responsible for all of NYC Health + Hospitals’ information systems and technology infrastructure; providing comprehensive IT services and programs to support the organization. EITS manages over 1700+ applications, two parallel processing data centers, and infrastructure distributed across of 11 acute hospitals, 4 nursing facilities, 6 diagnostic and treatment centers, more than 70 community based clinics.

The department is engaged in hundreds of initiatives, programs, and tactical projects every year to support the Corporation's goal and objectives, improve the patient care experience, meet growing healthcare reform requirements, and better position the organization for the future. A comprehensive governance process is in place to help the Corporation prioritize IT projects, and ensure alignment with strategic goals and objectives. In addition to implementing new technologies, EITS is responsible for maintaining the existing IT environment and sustaining day-to-day operations.

Our Health Information Technology Prioritization Steering Committee continues the work effort of prioritizing the highest strategic IT projects (10) listed below:
 Epic Electronic Medical Record (EMR) Initiative
 Enterprise Radiology Integration Initiative
 Enterprise Resource Planning (Project Evolve)
 Clairvia
 2018 Meaningful Use Demonstration Initiative
 Enterprise Biomed Initiative
 Enterprise Capital Restructuring Finance Program (CRFP)
 Enterprise Provation Medical Initiative
 Pharmacy Enhancements Initiative
 Unified Communication

On May 31, EITS’ Nursing Informatics System Advisory Group (NISA) sponsored its 7th Annual Nursing Informatics Conference at NYC Health + Hospitals. The event drew a crowd of over 100 professionals with an interest in how information technology (IT) is bridging the gap between health care and hi-tech.
Like last year’s event, NISA conferences focus on nursing informatics and how its members can use that technology to advance care while advancing their own careers. Its members have been very active in a large variety of programs, including acting as Super Users in the H2O electronic health record system (since its first rollout), outside training sessions, certification review classes, attending local educational conferences, and cheering on their members’ successes.
NISA Co-Chair and Assistant Director, Information Technology, kicked off the program by welcoming everyone and talking about EITS leadership’s support for NISA and its programming. He was joined by fellow Director, Information Technology. She thanked the attendees and talked about the fact that informatics is becoming a more widely-recognized field of study and practical application.
Associate Executive Director, H2O Clinical Implementation, spoke on behalf of senior EITS management. She said that she, and most of those in attendance, is a nurse and she understood the dedication of everyone who wants “to learn new ways to serve patients” with IT.
Key Note and Guest Speakers
The key note speaker of the event was the Chief Nursing Officer (CNO) for Health System Operations for an NYC Health + Hospitals partner. She talked about Florence Nightingale, a pioneer in the nursing profession and her impact to this day and focused on the Civil War heroine’s use of data to treat soldiers and how that is the basis of modern-day health care informatics.
CNO of North Central Bronx, talked about how new technology like the H2O system (“I am so looking forward to Epic!”) will change patient treatment for the better with the use of metrics and other data. She reminded the audience of the various “leaps forward” that affected health care in general, and nursing in particular.
The Director of Infection Prevention and also an Association for Professional in Infection Control (APIC) Fellow has worked on infection prevention with a wide variety of health care organizations. She talked about the role informatics plays in her specialty and how “numbers don’t lie” when it comes to tracking infections.
Panel Discusses Mentorship, NISA
The formal program concluded with a panel discussion on mentorship, led by the Director, Information Services in EITS. The dais included CNO, Metropolitan; CNO, Woodhull. The questions focused on the benefits of mentorship and then touched on the role it plays in health care, nursing, and in general.
The audience asked several questions about each panelist’s experience as both mentor and mentee. Each answered that they had been in both roles and even pointed out people in the audience that had been (or currently were) one or the other to them.
Throughout the session, audience members who were presenting innovative ideas via boards got up to speak to the group. Several said they had been inspired by previous NISA events to create their boards and show them to their peers. Each said it was an important moment for them both personally and professionally.
“I think this program and NISA itself is a large mentoring organization,” said one audience member. The audience seemed to whole-heartedly agree.

Across the nation, more health systems like ours are turning to care management to help high-risk patients stay healthy and out of the hospital. Care management integrates medical, behavioral health, and social services to better respond to a patients’ many needs. As a new strategy to improve care and increase resources for our most vulnerable patients, the NYC
Health + Hospitals/At Home division has transitioned to the Office of Population Health. The At Home division has also been renamed: NYC Health + Hospitals/Community Care.
Our health system’s Community Care team, which includes more than 600 dedicated employees, reaches outside of the walls of our hospitals and health centers to ensure that our patients’ access to high quality comprehensive care and support continues when they return to the community— wherever that may be.
Community Care provides services in every aspect of the community, wrapping around our home care, care coordination and care management services to support our high-risk and high-need patients. With the integration of Community Care with the Office of Population Health, these patients will benefit from more comprehensive programs and services that are informed by additional data and expertise on care management.
“The future of healthcare will increasingly center around services delivered in patients’ communities and their homes.” “Community Care is leading this transformation at NYC Health + Hospitals, to better meet patients where they are, on their own terms.”
Community Care serves more than 10,000 patients through 4 main programs:
1. Home Care - Our Certified Home Health Agency serves an average of 1,200 patients and provides community-based clinical services including adult and pediatric nursing, rehabilitation, and social work services, usually after a hospital stay.
2. Community Care Coordination - Serves two different groups of patients with specific needs.
Health Home – is a network of internal and external Care Management Agencies, designated by the NYS Department of Health that serves over 7,000 adult patients. Health Home provides assessment, care planning, case conferencing, and social support linkages for the chronically-ill who may experience challenges with food insecurity, financial support, homelessness, and the criminal justice system.
Behavioral Health - Assists more than 600 eligible patients with chronic behavioral health conditions (such as bipolar disorder, schizophrenia and major depressive disorder) to gain access to specialized health plan benefits including home and community-based services.
3. Complex Care – Our joint home care and care coordination service serving about
500 homeless patients with multiple chronic health conditions who are residing in homeless shelters, or are being served by a specialized clinic at NYC Health + Hospitals.
4. Community Care Management
Care Transitions – Since the start of the year, our specialized nurse-led telephonic care coordination program has supported 1,500 high-risk patients in safely discharging from our hospitals into their communities with connections to home care, primary care and social support services to help reduce readmissions.

On June 26, EITS’ Business & Development Partners hosted a Pride Month event/Webex. It featured a Senior Director of EITS, who detailed her life transformation and how it has affected all aspects of her personal and professional existence. It was part of a series the team has been doing for EITS staff, including a Soul Food lunch for Black History Month, Women’s History Month TED Talks, and a “Dos de Mayo” luncheon.

This program had a large group attend in person. Dozens more tuned in online.
A Business & Development Partner moderated the event. She and her colleague were instrumental in organizing it.

An Associate Director within the Office of Diversity and Inclusion, also spoke. She talked about the role she plays for NYC Health + Hospitals staff in general, and her work with the Senior Director during her transition in particular.

The senior director who was among those profiled in the Insider for Pride Month, spoke about her transition in context of her overall lifetime. She described her experiences from childhood, in previous jobs (mostly on Wall Street), and finally, with her eventual transition while working at NYC Health + Hospitals. She spoke about the ups and downs of the process and she credited her “EITS family” for their “phenomenal” help and acceptance.

No Roadmap, But a Question of Policy
During the question-and-answer portion of the event, the senior director joked that while “there is no roadmap” in the process, she is a very methodical person. So, once she was ready to move forward, she had a question for the associate director:
“What is the corporate policy for transitioning?” This elicited good-humored laughter from the audience as there is no such policy.
After the program was over, there was a “Pride Celebration” for attendees, who snacked and socialized. Many asked senior director questions and thanked her for sharing her story.

After only 10 months, the NYC Health + Hospitals plan to transform ambulatory care has led to better continuity of care with primary care physicians, shorter wait-times for appointments and faster access to medication renewals for patients. Based on the success of the first full pilot effort at NYC Health + Hospitals, the new scheduling system is currently being rolled-out across the health system and is expected to be in place system-wide by December 2019.
The NYC Health + Hospitals Adult Primary Care Clinic, which serves approximately 30,000 patients annually, became the first site to pilot the new patient-centered scheduling system in August 2018. The hospital’s ambulatory care team worked closely with the health system’s Call Center agents to develop call scripts which emphasized continuity between patients and their Primary Care Providers (PCP).
The clinic then re-designed their appointment templates to match the new scripts. One major objective of the ambulatory care transformation plan is to reduce the use of the emergency department for non-acute needs. Also, by ensuring that patients see their Primary Care Physician more consistently, patients will be less likely to have unnecessary tests ordered and clinic efficiencies will be improved. Ultimately, the series of strategies are expected to improve clinical outcomes for patients facing chronic conditions such as diabetes and hypertension.
So far, results at NYC Health + Hospitals are promising. Appointment wait times decreased from 52 days to less than 14 days between January 2018 and January 2019.
Wait times for follow-up visits are now less than one week.
“Establishing a solid patient-provider relationship and guaranteeing timely access to care are the backbone of high-quality primary care. We managed to accomplish this in a short amount of time and with a lot of team work, and we are very excited for our patients and providers,” said the Clinical Chief for Ambulatory Care at NYC Health + Hospitals and Clinical Director of Ambulatory Care at NYC Health + Hospitals.

Early results from the 5-point transformation strategies implemented at NYC Health +
Hospitals include:
1. Improved Continuity of Care
The frequency at which a patient saw their assigned primary care physician increased from 50% to 87%.
2. Patient-centered Scheduling
New scheduling templates with appointment slots that opened on a daily basis have assured availability and have freed up time to accommodate same-day appointments.
3. Expanded eConsult
More than 1,700 eConsult referrals are being made every month from NYC Health + Hospitals ambulatory care clinics alone. The eConsult system has gone live at more than 130 clinics across the health system, and over 100,000 eConsult specialty appointment referrals have been made, improving satisfaction among patients and providers.
4. Increased Clinic Efficiency
Physician Assistants (PAs) who staff the call center during normal business hours have been filling medication renewals—which has reduced patients’ clinic visits.