In early March, the Tietjen Lab offices on Amistad Street and Cedar Street were closed amid the COVID-19 lockdown, and the staff of 10 people began working from home. Greg Tietjen, PhD, assistant professor of surgery (transplant), bridges the disciplines of biophysics, bioengineering, and transplant surgery. In his lab, students and technicians examine organs that were donated but rejected as unsuited for transplantation. Rather than seeing the organs go to waste, the researchers study them to better understand the mechanisms of pathophysiology so they can guide the design of new precision therapies. Because Tietjen’s is a tissue-based lab, the core mission had to be put on hold.
Instead of twiddling their thumbs when the shutdown order came, Tietjen and his colleagues did something bold: they transformed the way they work. “The shutdown was a blessing in some ways,” Tietjen said. “It allowed us to focus on the inefficiencies and flaws in the system so we could figure out ways to make it better.”
Today, the lab has a new rule-based workflow and new project management software. The goal is to run the lab with the precision of a hospital operating room—managing the entire end-to-end process from intake of organs to editing and reviewing of journal articles. IT mavens may be tickled to learn that the lab adapted a Salesforce customer-management software system for its use. Instead of keeping track of sales prospects with it, the staff members track human organs.
Indeed, things are being done differently in offices, classrooms, and laboratories across the Yale School of Medicine campus. Think of it as the virtual office coming to the med school. And while some practices will revert to the old normal when the threat of COVID-19 recedes, others will remain—for a simple reason: they are better ways to do things.
Michael Schwartz, PhD, associate professor of neuroscience and associate dean for curriculum, said he believes the response to COVID-19 has brought a fundamental change to how many faculty members view their work. By their nature, universities respect and support the independence of faculty members. That approach fosters great research, teaching, and innovations in clinical practice. But it also tends to make academic organizations less efficient and less agile than the best-performing corporations. In order to respond to COVID-19, faculty members have been forced to depend more on technology; to formalize the way they get things done; and to be more collaborative and responsive to each other’s needs. “It has driven us to be a better organization,” he said. “We understand better how decision making is done, and how to plug in to get the things we need quickly.”
Because so much work is being handled remotely, information technology has assumed a far greater role. In fact, the response to COVID-19 is amplifying a technology management trend that was already underway—centralization. For more than a decade, the Yale School of Medicine had handled its own IT; however, Ted Hanss, MBA, was hired two years ago as associate chief information officer reporting to Yale CIO John Barden, MBA. Hanss’ task is to integrate the school’s IT with the overall university operations and to standardize technologies and management practices. He supports IT for the Schools of Medicine, Nursing, and Public Health, and for Yale Health.
Yale got a jump on remote working because it had already adopted Zoom, the video conferencing system that is commonly used. With the onset of the pandemic crisis, use of the technology ramped up overnight and network capacity was expanded. Because everybody was working remotely all of a sudden—even call center employees—IT teams had to toil seven days a week providing people with the computers and networking setups they needed to do their jobs. The team even installed personal WiFi hotspots for some people living in New Haven-area neighborhoods without good Internet connectivity. With all of this technology in place, many employees will be able to work from home after the COVID-19 risk subsides provided their supervisors and job situations allow it.
Hanss says the crisis has created an opportunity to rethink how and where work is done. An institution that discouraged remote work previously now makes it easier. It’s even possible that in the future, some people who are hired from elsewhere in the United States won’t have to move to the New Haven area. That’s a big deal in situations where two members of a family are upper-level professionals. Hanss is a case in point: he lives in New Haven during the week and goes back to Michigan on weekends to be with his wife.
When the crisis struck, Yale Medicine’s clinical practices switched to telemedicine as much as possible. That shifted back to more in-clinic visits as the risks receded, but Hanss expects a sizable slice of medical care to be delivered online over the long haul. He is also implementing technologies to make the clinical practice more efficient. For example, previously, many of the individual clinical departments had their own physician scheduling systems, some of which were low tech. Now Yale Medicine and Yale New Haven Health are finalizing a plan to move all departments to the same online system. Many other office processes are going digital now as well, including moving to online forms to expedite transactions and reduce data transcription errors. “We’re doing a complete digital transformation,” Hanss said. “There’s a potential to have a much more efficient institution.”
Teaching is also undergoing a transformation. Faculty members scrambled to move their classes online—again using Zoom. Although students and teachers lost the immediacy of face-to-face interactions, they quickly discovered that some tasks are better performed when carried out virtually, said Schwartz. The chat, two-way screen sharing, and polling features in Zoom enable people to do things that aren’t possible—or as easy—in the physical world. Teachers also discovered that the breakout room feature is a boon. In normal classroom situations, breakout groups often find the conversations bubbling around them distracting. In a Zoom breakout room, they’re cloistered. “In the future, we’re going to have a lot of blended learning,” Schwartz predicted.
The new communications and collaboration technologies have enabled work groups to experiment with new processes across the board in departments and functions. Because John Eberhart, a licensed architect as well as an associate IT director, couldn’t see his team members in the flesh, he started using an online system to manage relationships and communicate with the entire team in a virtual space. One result: he’s changing the process that his group uses to provide IT support to research labs—with the goal of reducing the amount of time and effort that investigators have to spend on technology. Other groups are using various permutations of agile project-management disciplines to improve accountability and get work done more rapidly.
While many workflows will return to the old normal after the threat of COVID-19 passes, a number of faculty members say they expect that the best of the changes will stick. One of them is Harlan Krumholz, MD, SM, the Harold H. Hines, Jr. Professor of Medicine (Cardiology), professor in the Institute for Social and Policy Studies, and director of the Yale New Haven Hospital Center for Outcomes Research and Evaluation (CORE). His staff of 150 people moved online and adapted quickly. He said the mindset in academia changed in the direction of more data sharing, among other salubrious effects. His colleague Wade Schulz, MD, PhD, assistant professor and director of the CORE Center for Computational Health, created automated dashboards for hospital administrators and clinicians to make it easier for them to organize care and collaborate on research. “People jumped in and innovated,” he said. “I hope we can retain this spirit of collaboration, generosity, and creativity.”