Aaron Burd, CISSP – Excela Health

Beginning last June, patients staying in the intensive care unit (ICU) of Pennsylvania’s Excela Health Westmoreland Hospital were given some spirit-raising news: they could now watch on-demand movies, check their e-mail and view tailored patient education materials through their televisions.

Truth be told, Aaron Burd would prefer to talk about the other upgrades. The ones he says will help improve patient care dramatically —and even save lives. Like the new vital signs integration, which can relay a patient’s heart rate and blood pressure directly to a doctor or nurse’s iPhone. Or the personnel tracker that keeps tabs on when staff are in a room.

The interactive TVs might make a patient’s stay more comfortable, but it’s everything else that’s making their visit as short as possible.

“The overarching goal was to take a dated ICU unit and make it more patient- and staff-friendly,” says Burd, director of technology and information security for Excela Health, which owns and operates Westmoreland Hospital. “The reality of what goes into it is a bit more complicated than that.”

Making room

To ensure the renovation was completed as quickly as possible, Excela had to temporarily relocate the entire ICU—upwards of 30 patients—to the nearby expanded nursing floor.

As part of a multidisciplinary unit, Burd and his team spent the next eight months redesigning each of the ICU’s 22 rooms, outfitting them with new beds and power poles, which house outlets for vital monitoring equipment. GetWellNetwork, a company specializing in patient engagement tools, created educational resources for patients that could be accessed through their TV’s, including videos related to their health conditions.

But while patient comfort remains a priority, Burd cites the ability to track nurses and doctors making their rounds as most transformative.

“When a care provider enters a room, integrated RFID ‘smart walls’ identify the individual, log the activity and then display the face and name on a small screen near the door,” Burd explains.

Game-changing? You bet it is. Award-winning? As of December 2018, when Westmoreland received the 2019 ICU Design Citation Award from the Society of Critical Care Medicine, Burd can wield that superlative as well.

But he and his team are doing more than just overhauling Excela’s existing IT infrastructure; in some cases, they’re building it from scratch.

Every second counts

Owing to the federal government’s 2017 decision to change its reimbursement policy for Medicare and Medicaid, health care systems like Excela—which operates three hospitals, three outpatient care centers or “medical malls” and 75 doctors’ offices among other services in the Greater Pittsburgh area—have begun to direct more resources to outpatient care facilities.

Completed in February 2018, the latest Excela medical mall—Excela Square at Latrobe (ESL)—reflects this industry shift and includes a bevy of exciting IT features: TVs that can be synched instantly with in-room computers, allowing physicians to display things like x-rays and charts for everyone to see; conference rooms with full AV capabilities; and more.

But it’s the facility’s virtual desktop infrastructure, or VDI, that’s proving the biggest boon for efficiency and security alike.

Partnering with their longtime technology VAR, Rolta Advizex, Burd and his team designed and installed a complex VDI infrastructure. Thanks to 375 virtual desktop clients—computers, laptops and other devices—physicians can now save a document in one location and, with a simple flash of a digital ID badge, pull up that same information on another device in a matter of seconds.

“It might not seem like that big of a deal to patients, but when you add up the time saved throughout the course of a day, the impact on efficiency is significant,” Burd explains. “If a doctor can complete a patient meeting in five minutes instead of 10—that changes the game.”

What’s more, because all VDI data is being stored on off-premise servers, computers housed at Latrobe are virtually immune to outside cybersecurity breaches. In the event a certain VDI client or group of clients need to be shut down for fear of being compromised, Burd’s department can flip that switch with just a few cellphone swipes.

Patients first

Excela’s security measures don’t end there, however. In late 2018, Burd rolled out Umbrella, a Cisco platform that monitors web activity—for http and https domains specifically—within the Excela environment.

Now, instead of blocking sites one at a time, Umbrella uses advanced algorithms to determine whether a site is safe or not. That, in turn, helps Burd and his team minimize instances of phishing, where hackers send cleverly disguised emails designed to extract sensitive information—Social Security numbers, system login credentials and so on.

“Cybersecurity is the single biggest issue we face in health care today,” Burd says. “User education has to be part of the equation. But unless you have best-in-class tools to back it up, it’s only a matter of time before a breach occurs.”

For Burd, security is about more than just protecting patient information. It’s also about protecting the patients themselves.

To address the region’s growing opioid crisis, Excela will soon introduce two-factor authentication for all narcotic prescriptions. Before a doctor writes a prescription—say, for Vicodin or Oxycodone—they first have to log into a special portal. Once the prescription is issued, they receive a token or number verifying the transaction.

On the horizon

Eleven years after joining Excela as a network operations manager, Burd marvels at how the health care landscape has changed: from gigabytes to petabytes of data storage; the rise of blockchain; the scourge of security breaches.

Still, Burd says he’s never been one for looking back. And with a litany of big-ticket projects on the docket—including a genometrics program that will use machine learning to prescribe more patient-specific medications, possibly eliminating needless trial and error—he won’t need to anytime soon.

“We’re seeing health care become much more decentralized, and ultimately that’s going to be a good thing for the patient,” Burd says. “The goal is to make sure you’re giving them the best service, even if that means more remote in-home visits.”

After all, if people are going to order dinner and a movie, they’d probably prefer to do it from their own couch. Why not do the same with medical care?