Adapting Technology Change in Rural Areas

By Gregory Bryant, CIO, Gov. Juan F. Luis Hospital & Medical Center

Healthcare in the United States is hard as is: without a global pandemic. But imagine being a CIO going through this in an area where there are financial, structural, and staffing challenges. How do you take a health system that has been in recovery for over five years to 2022 in a year?? The answer: If I knew that, I would write a book and sell it!

I am a [fairly new] CIO from the Southeast but now working in beautiful St. Croix in the US Virgin Islands. In 2017, two category five (5) hurricanes ravaged this area back to back. The damage can still be seen today and nowhere more evident than the hospital I work in. Since then, we have had to close areas due to not being safe for patients or staff or items being broken beyond repair. It is a struggle, but the team there has been the greatest group ever. They come in despite all of the setbacks and give 110% every shift and provide the best care.

I always like to sit with staff who have been at the facility the least amount of time; the reason for that is they have not been indoctrinated in the ways and are less resistant to changes.

I am happy to say that we are near completion on a temporary hospital and will start building a brand new hospital to provide the top-notch service to the community and all those who travel to the USVI.

With all that, healthcare and, more specifically, the Healthcare Technology industry does not stop while we wait for a new facility. And epically does not when you are the only acute-care facility on the island. When I arrived, I made it my goal to accelerate technology through all areas to improve patient care, financial outcomes, and overall satisfaction.

An island that is eighty square miles is a lot like rural areas in mainland United States. I have worked in several rural areas and one thing I can tell you is this: change is difficult in technology. Even if you know you are improving all aspects of the health system, you will face resistance. There are so my times I have been told by staff that they like the way they do a process because that is how we always do it.

So how do I combat this: well, I find if you sit with people on a personal level and explain the current process and show them the new process that does have a positive outcome…but not all the time. I once (true story) had a Director of Nursing quit on me the day of go-live because she could not handle the technology being used. I always like to sit with staff who have been at the facility the least amount of time; the reason for that is they have not been indoctrinated in the ways and are less resistant to changes. I then go to senior staff and explain them that I am there to work with them and see what their true concerns are. Sometimes I find that there is just a fear of the unknown. Everyone is scared of the unknown: that’s human nature.

I also want to say to all of my clinical friends coming from a non-clinical person: I get it. You men and women have so much to do with patient care that one more software or device seems like too much. We are not trying to make your life harder. I feel for new staff who get frustrated with technology, especially in areas where technology is not at the forefront. We on the Healthcare IT side want to work with you and bring the best outcome for everything needed.

We are all here for one reason; To care for the patient: Full Stop. I think the care team of a patient is not just those that are in the room, but those outside of the room as well. The environmental services workers who clean the room. The dietary department who makes sure you [and sometimes your family] are nourished. The medical records department who either retrieves your records or prepares them if you need them. The facilities department who keeps everything going 24 hours a day/7days a week. And yes, your neighborhood IT guy who makes sure your Wi-Fi is working so you can catch up on your favorite show or play your favorite game.

We don’t like all the new tech sometimes, but we embrace it. It is like a new drill for a surgical case or a new modality in radiology. It comes with the jobs we do and the times we are in. Think about it, ten years ago, the cryptocurrency did not exist and electric cars were being laughed out of conferences. But now, everyone has embraced these things like the drill or modality. It is not easy all the time, but it is for the greater good. It just takes everyone involved to make the transition smoother. Technology may start with the CIO, but it ends with the entire team.