AltaMed’s digital healthcare transformation

Raymond Lowe, Senior Vice President and Chief Information Officer at AltaMed Health Services, discusses clinical system transformation and remote working

Non-profit healthcare company AltaMed Health Services was founded as the East Los Angeles Barrio Free Clinic in 1969, with a mission to provide healthcare to the underserved Latino and multi-ethnic population of east Los Angeles. There was a lack of healthcare available in this area and today they're one of the largest community health centres in the country, serving nearly 300,000 patients with more than 1,000,000 visits a year. 

AltaMed serves everyone and anyone independent of their ability to pay or their immigration status. “We welcome everyone at AltaMed and we are here to help them with primary care and their health concerns, providing quality care without exception " Lowe says. "At our core is social justice."

Lowe joined AltaMed in January 2018. The company had been going through a decade of "explosive growth", with the number of patients they serve having increased tenfold. 

He launched their digital transformational journey with a focus on healthcare’s quadruple aim: improving quality, improving patient experience, improving provider satisfaction, and lowering costs. In order to do this Lowe set about developing a comprehensive plan that was rapid, agile and included input from business stakeholders in clinical and financial operation areas. "A DevOps initiative or technology without operational buy-in will likely not deliver the right outcomes," Lowe says. "I always keep in mind what the corresponding workflow is and what the KPIs are that we need to meet for the organization, thinking not just in terms of technology, but from an operational perspective." 

"Digital transformation is not easy," he adds. "Aligning the organization requires flawless delivery of operations. Good IT requires detailed planning and strong operations to ensure the organization will be successful. Ultimately, I think IT needs to run like magic." 

The last two years have certainly produced many benefits. AltaMed has hardened core services, particularly uptime and critical services, implementing cyber solutions to address threats that arise with increased remote working and telehealth solutions. The company has further been able to extend meeting services so remote workers can collaborate seamlessly regardless of location and the number of attendees. As well as managing televisits and increased traffic to their patient portal, they've deployed the Epic electronic medical record system, a new managed care software solution. 

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Quotables

Through our digital transformation our patients will have access to healthcare through mobile devices, when and how they want it.

Raymond Lowe | Senior Vice President and Chief Information Officer, AltaMed Health Services

Virtualization has also been a key element. "We've been able to make our data centre to UTI tier III, and we've added 350 new virtual machines and 33 hosts in the last two years within the VMware environment," Lowe explains. 

To upgrade their network and cybersecurity AltaMed has relied heavily upon their partners. Lowe explains that there was technical debt when he first joined, and he needed to bring the corporation to an enterprise class. "Fortunately I have a good partner network with Cisco and Presidio, having worked with them previously at Dignity Health, and Red8 is an existing partner at AltaMed. We did a baseline gap analysis to plan how to correct the environment so we could be at an enterprise level. This involved collaborative working both with my technology team and my partners, and through that we developed a remote multi-phase programme. Ironically, most of it was actually completed prior to COVID-19."

"The partnership with Cisco and Presidio allowed AltaMed to transform the network, switch route, hyper converged infrastructure and cybersecurity. My entire digital, video and telehealth strategy is built upon this framework and we are able to work fast - taking the time to lay the proper foundation allows you to move fast and perform transformation at the speed of light. We also entered into enterprise licensing agreements in the Collaboration (Webex) and Cisco’s Security Umbrella.” 

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A partnership with NetApp and Red8 allowed them to simplify data management and non-disruptively scale capacity, while cost-effectively supporting their general-purpose business applications. Red8 also worked with Lowe's team consolidating fragmented infrastructure, allowing them to stabilize and grow the core of their managed care business. They also assisted in overall design and deployment of data protection, retention, and encryption.

"Partners really help to shorten the time to market. No organization has all the talent that's necessary, and great organizations are built on great opportunity. I've been very fortunate to have a very strong partner network that has been an extension of my team." Lowe says. 

The Covid-19 outbreak has substantially changed the way they work. In keeping with social distancing guidelines, AltaMed has expanded video and telephonic appointment They opened nine outdoor testing sites including in some places where there was no power or network services. "We had to figure out how to deploy corporate wireless out into a parking lot to support a clinic," Lowe explains. "From an application and DevOps perspective, in days we deployed a brand new build for Covid19 to support the testing sites”. We needed increased infrastructure uplift for virtual meetings to provide rich video experience for our patients, providers and employees. For social distancing and remote work we deployed 800 laptops over a three-week period. Working with Cisco and Presidio helped us accelerate the implementation of a thousand remote workers, which happened in a matter of days." 

Lowe says this was a real test as to nimbleness and agility. "Our teams excelled during this crisis, meeting the needs of our employees and continuing to care for the underserved population of Southern California." 

Looking ahead, he says some of these changes will remain in place. "Social distancing is now the norm, and certain jobs may not return to the office. From a technical perspective we need to ensure that we have a highly reliable network, connected in a secure manner, allowing employees to be productive either on site or remotely."

"From a patient perspective, many people are very concerned about being in crowds, so we are looking at shifting the way we provide care with a much heavier emphasis on video and telephone services." We are deploying patient-centric care with flexible walls, meaning our patients won’t have to come to a clinic to see a provider. They will be able to obtain care from their location on their schedule. Also for Covid 19 testing we are deploying temperature kiosks that prompt patients and employees to answer CDC guideline questions to ensure the safety for everyone.” 

Their digital journey has already seen them expand into these areas and they are prepared to continue this digital transformation. For patients enroute to an appointment, AltaMed has enabled them to check in to their appointment on their phone, and wait in their car until someone is ready to see them. They will then receive a text message reminder to let them know when to enter the medical building. To improve the quality of care in the home for chronic disease management, AltaMed is also working on remote patient monitoring for people with chronic diseases, for instance by sending out glucometers to track weight and blood pressure in patients with diabetes, congestive heart failure, hypertension and COPD. Formoms, they are deploying an application that will provide education, tracking and support during their pregnancy journey. .   

AltaMed Health Services is an organization that lives its mission and values providing healthcare to the most vulnerable and underserved communities. “Through our digital transformation, our patient will have access to their providers from their mobile device or home when and how they want it.”

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