All Hands On Deck

By Craig Norquist, MD

I have to admit, my military background kicked into gear as soon as there was concern that this was a pandemic that we needed “all hands on deck” in order to be successful. As an ED doctor who has active non-Hodgkins Lymphoma, i was torn on wanting to work in the department as a provider and leader, thinking i could provide some sense of calm and leadership in the face of unknown.

My ‘other role’ in healthcare is the CMIO (Chief Medical Information Officer) for our hospital network. We have 5 hospitals, one freestanding ED, and some 50 clinics that i oversee in regards to the EMR and all things digital. I have been working at least 12 hours per day behind the computer, in meetings, and one on ones to optimize the EMR to make it as helpful as possible. Early in the course of this it was helping to create and optimize alerting systems for those patients suspected of having the virus due to travel and symptoms. We also had to create order and resulting systems for testing and tie alerts to the results etc.. My time is hopefully productive in keeping the physicians protected from excessive clicking or documenting as well as optimizing their time on the computer.

I have been scheduled to work a couple of shifts but have been called off due to low work load as our volumes are currently down due to the social (physical) distancing as well as people being afraid of coming to the hospital and getting infected. This makes my wife happy, but honestly it makes me feel as though I am ‘hiding behind the computer.’ I am reassured by my ED colleagues, other doctors in the system, as well as the IT personnel who I work with that my time spent as CMIO is invaluable to more people than if i was working a clinical shift. Someone in IT told me that “there are lots of people who can be ED doctors, but far fewer who can be CMIO.” I have to admit that did help me reconcile my guilt with the long hours i am putting in with informatics.

It bothers me deeply that there are physicians and healthcare workers who are ‘on the front lines’ are sometimes putting themselves in a precarious position due to limited PPE. We are doing everything from trialing a video visit platform to minimize exposure time, to coordinating with our state health information exchange a way to get discrete data feeds of COVID test results as soon as a patient registers for a visit or in the ED.

Each day brings new issues and hurdles, but it is exactly in times like these that we earn our trust and mettle amongst our colleagues. And in another, perhaps realistic but warped way to look at it, i might still be available as a second wave of providers that might be needed to care for both the providers who become ill or the second surge of patients.

Either way, I have never been more proud to be a physician and hope that we can continue to keep the wave of support and recognition going in order to regain the love and joy of caring for so many of the doctors who have lost it and become burned out.

Craig Norquist, MD is the CMIO for HonorHealth, a 5+ hospital healthcare network in Phoenix and Scottsdale, Arizona. He is also an Emergency Medicine physician.