Getting the most out of technology starts with a solid foundational infrastructure. As an increasing number of senior care communities from senior living to home health begin to turn a discerning eye on their technology investments, infrastructure considerations become paramount. Where is the first place to start when updating an old technology ecosystem? How should you be considering the cloud and outsourcing support? What are the appropriate data protection measures? How should IT operate in a way that supports the changing needs of senior care?
Our latest Q&A with Kathy Burkle, Chief Information Officer, Jewish Senior Living Group, addresses all those and more and highlights her experience evaluating technology for senior care and building a solid technology infrastructure.
CDW: Please tell us a little about your community and your responsibilities.
KATHY: Jewish Senior Living Group is an innovative and growing network serving senior adults and their families across the San Francisco Bay Area. The Jewish Home of San Francisco and Moldaw Residences, Palo Alto, are part of this network. The 360-bed Jewish Home is the largest private, not-for-profit, skilled nursing facility in the state of California. Skilled nursing, short-term rehabilitation, acute geriatric psychiatry and research are provided in this CMS five-star rated facility for quality of care. Moldaw Residences offers 193 independent and assisted living units. Then we have an evolving component of our network called The Square, which will provide physical and virtual services, support and community for older adults, their families and caregivers both on the Jewish Home’s campus and in the community.
I’m the Chief Information Officer and I joined the organization five years ago, when I found a true passion for senior care. My prior career had been predominantly in high tech, but I think bringing some of the IT fundamentals and experiences of larger organizations has been a real plus. My team has responsibility for all information technology, infrastructure, business applications, hardware, software and service agreements. Anything that connects into our network or provides technology to the organization falls within our world.
CDW: Paint the picture for us: When you first started in your position, what did Jewish Senior Living’s current technology ecosystem look like?
KATHY: Absolutely everything in our environment was local on premise, even payroll. Everything was running in our small data center. Quite frankly, we didn’t have the staff to support it. We had no basic operational procedures and policies. We had 40+ applications where the documentation was stored in the head of the staff members. None of the software was current. The infrastructure was aging and, in many cases, end-of-life and no longer supported by the vendors. I can sit here now and say, quite honestly, we had a fairly serious crisis every week. We were constantly in react mode and we were in no position to look ahead because we couldn’t get our heads above water. Traditionally, in the not-for-profit environment, investments are not made as easily or as readily when it comes to technology.
So our mantra for about two years became “back to basics”. Assess, prioritize, plan and measure. We engaged support to complete key assessments of the infrastructure, specifically on the network. And we began implementing some of the necessary corrections, which meant hitting ‘pause’ on exciting, new applications.
CDW: Can you walk us through the key steps you took to get where you are now?
KATHY: One thing we did was immediately move our applications to the cloud. Any time a business application was either due for an upgrade, the vendor was changing support, we had a problem with it, or we were exploring a new application, we took that opportunity to seek out a ‘software as a service’ (SAAS) solution, or to third-party hosting opportunities for that application. We started with our most critical applications – our electronic health records, our financial applications, payroll. And we very methodically began moving applications, which afforded us the opportunity to gain better support, stay current with software levels and not bog down our very limited staff. Today, 90% of our applications are SAAS-based or hosted with third parties.
As it relates to our infrastructure, we had sizeable assessments done on the network and on our basic server and storage environment. We laid out a plan to upgrade our network, implemented new network equipment and installed robust Wi-Fi throughout the campus. We’ve reached the point where we really have a stable, reliable environment. The organization weathered a couple of challenging years, when government-based reimbursements threatened to be drastically cut. If those devastating cuts had been implemented, and if we hadn’t made some serious changes in our operations, we would have been out of business.
CDW: How did this change the IT experience for your community’s staff members?
KATHY: We successfully implemented a third-party managed service contract for some of our basic commodity services like network management and our help desk. As a result, we’ve seen measured improvement in customer satisfaction. We now have a more cooperative and collaborative relationship with the business. We also established standards from a hardware perspective and operating environments. Standardization helps to drive reliability. We put policies and procedures in place. As a result, we’ve been very successful at eliminating what I’ll call the “rogue IT.”
Over the years, I think IT professionals have slowly begun to learn that you can’t be the end-all ruler of the technology and manage in a vacuum. It became a personal objective of mine and my operations manager to drive the fundamentals of customer service. Stop putting up barriers and really working in a more positive, proactive, cooperative way.
CDW: So where is your organization headed now when it comes to technology investment?
KATHY: The Jewish Home has launched a major transformation effort of not only our physical campus in San Francisco, but also our services. We’re completely rethinking our business model so that we can better serve the Bay Area subset of the 77 billion baby boomers. People want to age in place where possible, which is why The Square is so important. How do we provide our services to people who aren’t necessarily living within our four walls? How does IT enable that vision?
For IT, the most significant piece of the Jewish Home’s transformation is that we’re fully engaged with the business leaders. IT is no longer the afterthought. Now we’re on the ground floor as our facilities are being designed and planned. We listen and collaborate on the development of the vision. In the senior care industry, there are thousands of vendors. We’re navigating the space to identify the products and services that help achieve not only streamlined workflow in our own buildings but with our entire community, including physicians, payers and providers in our network. Mobility is at the base of that, but so is interoperability and exchanges.
We’re also establishing an executive team IT governance process. Two months ago we did a full inventory on all the open requests, and we had a seven-year backlog. We’ve embarked on a program to eliminate the non-value added projects, and, most important, fully engage the executive team in defining where we’ll make investments and where we won’t. We’re looking at more outcome-driven decision-making, which allows us to be a bit more thoughtful and intentional about investment.
CDW: Do you have a guiding principle that helps drive your new vision?
KATHY: The fundamental guiding principle that we keep in the forefront every time we have a conversation is mobility. Mobility for caregivers, support staff, residents, our community that we intend to engage. So you can do things at whatever point in time you’re delivering care, at whatever point in time you need to schedule something, at every point in time you need to be engaged with a physician, even if they happen to be at another location. Mobility dictates that we need the most robust Wi-Fi available, extensive bandwidth to scale the entire community, and full redundancy because the network is the backbone for deploying full mobility.
CDW: It sounds like you do a lot of measurement and assessment. Can you elaborate a bit more?
KATHY: We do quite a bit of measurement in our service desk environment and that’s where we’ve had clear evidence that we’ve made improvements. We are now focused on a stronger linkage with the business. Measurement is clearly part of what we are defining in every significant project we’re doing.
CDW: What is your best advice for other senior living communities looking to invest in technology? What have you found the most helpful?
KATHY: We’re one of the original members of the new Aging 2.0 Alliance, we’re associated with Leading Age and the Leading Age CAST. We’re also members of more local informal networks. In the Bay Area, some of the CIOs in the not-for-profit senior care space have put a group together. We call each other, we ask for advice, talk through challenges. That’s been huge for us.
My overall advice, especially to the smaller senior care providers, specifically not-for-profit, is really partner where you can. Partner for commodity services and leverage your network, both formal and informal. Learn from others. I think there’s been too much reinventing the wheel. Most significantly: partner with your organization’s senior leaders. You need to be at the table working with them – laying out the plan.