Tips I learned running IT for the U.S. Air Force during 9/11

Wes Wright
Apr 15, 2020

COVID-19 is, simply put, a generational event. In my career, the only parallel I can draw is 9/11, when I was CTO and then CIO of the second-largest medical facility in the U.S. Air Force (USAF). COVID-19 is a worldwide event, however, one that affects every one of us in some way. 

During 9/11, the entire USAF healthcare IT team was laser-focused on supporting our pilots and protecting our citizens. We ran 24/7 incident centers and kept our headquarters apprised of our capabilities, often on an hourly basis. 

How does that compare to now? Just substitute “pilot” with “healthcare provider” – except now, our “citizens” are also part of the fight. We’re all fighting by using great hygiene (wash your hands!), maintaining the proper distances between us, and working from home (WFH).

I know your Healthcare IT teams have been working 24/7 to support your caregivers. They’re setting up tents, deploying equipment, bringing folks on board, and building order sets and logical locations in your EHRs. So, here are a few tips I’ve learned from my experience that may help get you through these challenging times. 

Make a checklist. Checklists help when we’re all this busy. Eric Neil, CIO of University of Washington, put together a great WFH guide -- including COVID-19 information that most clinical/operational will find helpful.

Check your Certs!! You don’t want an expired cert on your access gateway to completely shut down your remote access capabilities.  Heck, even Microsoft forgot to update their cert for Teams a few weeks ago—happens to the best of us, just don’t let it happen now!

Follow your technical stack. Trace the pieces from your remote access locations back to your applications. That is, how are your caregivers going to access from home, and using what physical devices? In the UK, for example, they considered sending folks home with their crypto keyboards/devices to maintain security and access national apps. Is there something like that you need to have? 

Barco monitors for radiologists can be tricky. Even from home, they need those monitors that are calibrated to the FDA standards.  Do you have enough licenses for the entire stack? Can you add VDI capability, for example, and can you add remote access capability (we’re offering some free licensing for this through July, if you didn’t know), can you add folks to your EHR?  You don’t want to be messing with licenses when you’re trying to scale up. 

Finally, how’s your bandwidth? This includes bandwidth for telemedicine and your team members with remote access. The second issue didn’t used to be much of a concern, but with about a 100% increase in WFH it’s something you need to pay attention to.

Manage your digital identifications. You’re going to have a bunch of new folks coming on board and a bunch of current folks switching roles. You still need to be able to protect your applications and data – and be able to prove you’re protecting them. And, when things get back to normal (will they ever, really?), you’ll be able to deprovision the right folks and move them back into their right roles. I’ve been bit on the deprovisioning aspects of this more times than I care to remember. I realize you’ll probably have to use more FTE to solve this problem for now, but an automated solution will do you wonders; when you have to time to look at one.

The major lesson I learned as a somewhat long in the tooth major during 9/11 was the value of constant communication. Constantly communicate up and down your chain of command.  In the absence of that communication it seems to be human nature to fill that communications void with the worse possible scenarios. Don’t let that happen. Your folks are worried about their jobs, about their families, about their friends and you can help ameliorate some of that worry just by communicating with them. Tell them what you know, be honest, be empathetic and most of all, be optimistic. That’s your job as a leader and citizen in these times.