Becker's Hospital Review

41 CIO / HEALTH IT cilities-oriented tasks in addition to leading the organization, Mr. Lind told Becker's. Over time, as more people moved around and the CEO retired, the responsibilities of the COO were passed on eventually among the CFO, CMO and CIO. Mr. Lind, who had been promoted from IT director to the CIO role to head up the hospi- tal's EMR transition consequently absorbed those IT and operational tasks that intersect- ed – a move that he considered relatively un- usual at the time for a CIO. "We thought it was a little bit of an outlier. Generally, the CIO and CTO roles are very fo- cused and not necessarily operational in that context, so we felt it was a little unusual," he said. "But I had some bandwidth having com- pleted our EMR conversion and I was able to take on the responsibilities in terms of just having the time to give to the different man- agers and the focus they needed. But, honestly, I wasn't aware that the industry was going this direction at all. It was more perhaps an oppor- tunity for me to grow in the role." For Mammoth Hospital, the decision to have Mr. Lind take on responsibilities including long-term facility and infrastructure master planning as well as operational strategic goals around growth wasn't necessarily the idea of having the CIO become the COO but rather more of an answer to the question "who can pick up these different areas and what makes sense?" he said. As he looks to 2021, Mr. Lind said while Mammoth Hospital does have a lot of long- term planning going on, the day-to-day is oen consumed by its COVID-19-related response. From planning and reorganization of the facility itself to messaging, screening, communications and lab testing, his daily fo- cus "is all around the pandemic." n How hospitals use algorithms to prioritize COVID-19 vaccine distribution By Laura Dyrda H ospitals and health systems across the U.S. devel- oped plans to prioritize COVID-19 vaccine distribu- tion based on the CDC's recommendations. Some organizations used artificial intelligence to develop an algorithm that helped to decide who would receive the first doses. Renton, Wash.-based Providence used an algo- rithm to decide how to distribute the vaccine. "We used a simple form to allow our caregivers to self-at- test to their risk and role," Executive Vice President and CIO B.J. Moore told Becker's. "Based on a series of questions, we had a simple scoring system that was then used to pri- oritize caregivers into cohorts." Washington, D.C.-based George Washington University Hospital also used an algorithm that took age, medical conditions and infection risk into consideration to decide when employees would receive the COVID-19 vaccine, ac- cording to The New York Times. The hospital used an em- ployee survey to gather information for the algorithm. However, the method used by some other organizations has come under scrutiny. Stanford Medicine in Palo Alto, Calif., used an algorithm to select the first 5,000 employees to receive the vaccine based on several factors to priori- tize those at high risk. According to a Dec. 18 article in the Times, the algorithm Stanford used assigned individuals a risk score based on age, job description and number of COVID-19 cases within their department. As a result, the initial vaccine administration left out more than a thousand medical residents as well as fellows and nurses who care for COVID-19 patients, while food service and environmental service workers were prioritized. The residents' age coupled with the inability to assign a loca- tion to them in the algorithm put them at a disadvantage, according to ProPublica. Hospital administrators did not review the list generated by the algorithm before beginning to administer the shots, according to the report. On Dec. 20, Stanford Medicine told Becker's it revisited the plan to better sequence vac- cine distribution going forward. North Country Healthcare in Lancaster, N.H., is not using artificial intelligence algorithms to prioritize COVID-19 vaccine distribution. Instead, the health system is relying on CDC and HHS guidance to rank employees and clinical providers by risk on a 1 to 100 scale. In phase 1a, the health system is focused on critical workers and distributing the vaccine to those willing to receive it. "There is a significant percentage that will not get the vac- cine," said CIO Darrell Bodnar. "It is not mandatory for any- one in our organization. As we move forward, non-patient facing staff will be included in phase 1b. There is also a priority list ranked in similar fashion. A lot of this has been managed through HR and employee health." Charleston (W. Va.) Area Medical Center established the prioritization algorithm without artificial intelligence. "We had a group of leaders who established tiers of asso- ciates to receive the vaccine," said CIO Daniel Stross. "The tiers were based on exposure risk. For example, an ED or ICU clinician would be head of an [information services] associate who has been working from home." At Deborah Heart and Lung Center in Philadelphia, CIO Richard Temple said the hospital set up a vaccine sched- ule emphasizing front-line, patient-facing workers first but staggered vaccine administration to make sure there weren't any large-scale adverse events. "We didn't want to be in a position where we would have a large number of clinicians unavailable simultaneously due to adverse reactions," he said. "As a small hospital, we are hoping that we can stretch our dose allocation to reach as much of our hospital staff as possible, thereby protecting our employees and our patients." n

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