WEBVTT

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Hello, I'm Julia King at idg and today,

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I'm thrilled to have with me.

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Christian Darby, who is the Enterprise?

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CIO and envision Healthcare?

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Hello Christian. How are you very well?

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Thank you for having a Julia.

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It's great to have you.

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It's good to see you again.

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And they're going to be talking about resilience and Dish and

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Healthcare and your strategy there.

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And let me just talk a little bit about Kristen.

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She is on the Salesforce help Cloud customer Advisory board

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Tucson ID gcio Advisory Board and I'm thrilled to say that.

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She was inducted into i d, g e,

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s t. I o n this year in 2021.

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So congratulations, Kristen very much.

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Thank you envision, Healthcare is a national Medical Group

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and we have 31,000 team members that includes 25,000 Physicians

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and Dance, practice providers that across the country care for

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32 million patients, and our communities across the US every

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year, that is approximately 10% of our population,

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which always astounds me that we touch that many in the community,

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but is always very powerful.

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When I reflect upon it every year,

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the care that we deliver really processed the spectrum of Specialties

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from operating rooms to emergency departments.

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Also in do Ambulatory Surgery centers in birthing centers.

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We are the leading provider of emergency medicine which is his

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last year of the pandemic certainly had a larger impact,

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which I'm sure we'll talk about more today and we as a provider

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in rases, we deliver the most colonoscopies,

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in the country helping patients detect and prevent.

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Colon cancer in my role as CIO we serve as a business partner

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to the clinical and business, functional leaders across the organization,

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really looking to identify opportunities for technology

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to provide value Drive efficiencies, and transform the way that

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work is performed the, the big attraction to me for technology

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has always been that.

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I love solving problems and that has translated into my domains

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of responsibility being around technology strategy operations,

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the cybersecurity area digital and product development

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in here at Envision Healthcare.

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It's a suite of Technology tools but with our largest being,

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in the distributed Radiology platform area,

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Well, you certainly cover a huge loss of the population,

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and provide multiple services and strictly being in healthcare.

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You've been at the absolute epicenter of everything for the last

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year and longer tell us more about how the Medical Group at Invision

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Health Care has responded.

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To the covid-19 crisis and how have you or how has your technology

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team. So it has been one of those years that when I reflect

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back, it's amazing.

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It's only been a year.

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So I originally in February 2020.

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I think we started by maybe January and February.

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We were monitoring things that were occurring overseas and just

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watching the news and the first

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Indication that we really had was when Wuhan have the walk down.

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We knew something unusual is happening because we've never

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seen anything like that.

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And the first reaction that I had was I anticipated supply

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chain issues because I had encountered that previously

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organization and had impact it in a chair delivery setting.

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And so, one of the things that we did was we immediately

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put in our orders for everything.

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We anticipated, we had budgeted anticipated ordering for 2020

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because we were concerned that we would not have access to equipment.

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So put in orders as we continued watching over the next few weeks,

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if he came clear watching what was happening in Asia and then

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eventually you're up that virtual care, may start becoming

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something that if this started becoming an issue in and the United

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States, that may become something that starts biking.

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So we did start to acquire some more equipment webcams.

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We already had appointment on order for tablets laptops xcetera,

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but many of it has started putting in some additional

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orders anticipating that that need, maybe they're which ended

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up materializing in the future.

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Once covid-19 reach the us, we mediately stood up additional

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resources for our teams that included making sure that we had

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24 x 7 command centers in place with Centers that were telephones

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website. Everyone just really needed information and resources.

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And so we made sure that those command centers were running

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with information being updated as quickly as possible.

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And that individuals knew where to go,

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we also stood up remote work right away and that included

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transitioning, 6000 clinical support employees from our offices

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to our remote work setting within a week.

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We did this much sooner than many other organizations

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very early in March 2020.

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And the reason we did that is we we knew that we needed our

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clinical support seems to be very stable and settled so that

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they were not in points of transition.

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In, at a point that are Healthcare Providers,

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were going to need them the most And so why we were starting

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to see numbers rise in some of the cities that were beginning

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to Surge in the beginning, the Northeast.

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And there was some in the Northwest we felt like our our schedulers

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or credential others.

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We just we needed to get the esteem stable so that we knew everyone was

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settled in there to support our clinician.

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We had to make sure HIPAA compliance.

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He was in place because everything was set up for an office

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setting. And that was not necessarily the case in the home and

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four for our non-exempt employees, especially that we're not

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necessarily setup. For remote work, they did many of them had

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never worked remotely, and that was a transition.

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So we wanted to make sure that that all went very,

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very smoothly. And I think the last portion of our set-up

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was really virtual hell and that was making sure our clinicians

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that we're going to need to have access to provide Virtua

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Health in a clinical setting had that access once they needed

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that. And that was really in our office based practices

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and also the clinical setting which we deliver 250,000 patient

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visit, super to hell since the beginning of the pandemic

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and continues to rise.

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What exactly did that entail?

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I mean, you mentioned webcams, did you need to set up additional

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vpns or get remote equipment to peoples home?

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How were you position to be able to do that?

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It sounds like you were right on top of the supply chain issues?

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And then of course, you have to take that home,

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So there was definitely planning that needed to happen but because

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we had were a large National company that had employees

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r, i t t m or D Works remote.

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We had groups of teams that either worked a hybrid schedule

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or the executive team and work remote.

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We had remote capability is certainly not to the level of extents

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that we switch to very quickly but the the areas that we really

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had to flex out very quickly we're in increasing infrastructure

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capacity. So everything from VPN terminal Services,

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network capacity, expanding product licenses with our stuff

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we're partners and expanding capacity of virtual call centers,

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for example. So we had that capability but very few

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Party members were trained on music match and it's because

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they had never worked in a remote capacity.

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Zipper example, our receptionist that at office buildings

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are in call centers.

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They didn't know that their voice over IP phone system could

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actually ring at their house and on their computer on a headset.

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So we had to order a lot of heads up and then trained everyone

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on how to get the extension to forward to their laptop and how

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to log in a virtual call center in answer the call.

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So we did a lot of that training,

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we created a lot of videos on how to do that and I think

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the biggest thing was

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Everyone on the team recognize the situation,

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recognize the level of intensity that was occurring in the amount

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of work that had to be done in a short. Of

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time. And it was amazing.

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How many people jumped in and might have said,

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this is not my normal daily job,

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but work needs to be done in this area.

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I will do that work today and help out in this area.

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So, we had people way out of their job description doing jobs

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that day because that's what needed to be done that day.

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The neighbor wants to make that suggestion one week and so I think

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culturally it was great to see everybody just come together

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with all hands on deck to say,

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what do we need to do to get the organization transition

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smoothly effectively and get everybody stabilize to ensure

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that the organization pivots and that were there to provide

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the services necessary to support our clinicians,

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getting to where they need to be to Surf Mesa.

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What is needed immediately Pops to mine for me?

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And you, you made mention of it.

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When I hear about remote work in healthcare is,

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is certainly a combined with HIPAA, you know,

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some of the height and privacy and security issues that are pressed

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in healthcare settings.

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And I mean, it supposed to the security is critical.

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And how did you educate?

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Your Workforce was not accustomed to working remotely on security

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and risk awareness and in this new work environment.

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So quickly. So we develop difficult, sure of security and risk

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awareness from the office to home.

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A couple of the things were we created some how-to guides.

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We did educational videos, we created some web pages of one of

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the things we knew is across r r e made,

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everybody was going to dobrik on 10th and learn differently.

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So In it, we knew that between covid their work environment

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changing, the amount of things changing personally,

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and professionally that they were absorbing a lot.

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And so we needed to provide things to them in an easy-to-understand

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manner. So we tried to do everything,

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very simple and very nonsensical term incident was took a lot

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of a lot of reiteration of of an in process region.

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But we got it there too.

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To a point that it hopefully resonated.

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Well, we also conducted a lot of simulated fishing test related

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to threats that were similar to actual threats that were occurring

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to build awareness.

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So, one of the things, unfortunately, that was occurring

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that I think we've all seen in the news is that

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And I think this happens with many natural disasters or any kind

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of Crisis, but during covid, 5/8 risk,

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has been up anywhere from my scene reported to the 400% number

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of cyberattacks. And a lot of it has been phishing attacks

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in so we might see that there was something around.

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Hi, there might be, are you eligible for a covid vaccine

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in the beginning?

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Or would you for hospitals?

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Could you potentially be a covid?

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Vaccine Distribution Center.

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This is in the beginning when the vaccines available,

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you know, click here to see if your facility might qualify,

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right? Well that might be tempting if you're a physician

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right to see or a hospital administrator or patients qualify

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for a clinical trial, any of those types of things might be interesting

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to hospitals.

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It was certain things being targeted to locations and also to

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potential employees. But there was also things being targeted

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individuals at their homes, just related to covid in general.

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So we were doing a lot of training for individuals that might

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be relevant to their home for personal protection and that got

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people more interested.

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At the same time, this was occurring,

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many people were being at home for schooling.

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So many of our our teammate had children doing homeschooling.

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There was a lot of ships around.

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How do I have my children at home on the same connection

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as we're not doing work?

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So we were trying to educate on.

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How do you keep work information separates in private from schooling

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information. So a lot of that type of education we were trying

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to provide but also benefit the family in Waze That they were

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learning about safe cyber practices for home.

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At the same time, they were learning how to keep things safe

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for their family complex.

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What you have by sending pretty much the entire Workforce

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to execute their their daily jobs remotely and also the kinds

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of agile responses that you've had, and I guess here,

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I'd love to throw things forward a bit.

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And and asked, you know, how has this,

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what's happened in the last year, your response to it,

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what were well, maybe what didn't work so well.

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How has it impacted?

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You are a definition of business, resiliency for Invision

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Health, Care going forward.

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What kinds of building blocks?

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Do you see yourselves expanding on to be able to respond

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even better going forward?

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Well, we certainly hope that this will all be learning that

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we don't ever have to put it into practice,

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but knowing that things are never stable.

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I think learning set word Innovations can continue to benefit

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from is

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really moving from business continuity that organizational

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resilience in in, that's really around expanding Who's involved

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in the planning.

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And so these things can't be thought of as as discrete exercises

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or discrete instances.

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So you know what, you think of I can remember planning for disaster.

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Recover activities years ago?

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You would think of, you know, what,

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a power failure or a, you know,

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there might be a plumbing break at the building and you have

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a issue that isolated to one building.

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You know, this particular situation for example is is interrelated

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and Global, right?

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Its economic health care in, its

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Happening to the multiple sectors.

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And with that, you have to respond in a way that allows you to

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continue to operate deliver your services as an organization,

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effectively end still deliver while managing unknown circumstances

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despite that are going to be different with each situation.

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And so that requires a multidisciplinary approach and the plans

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have got to be well practiced, and you have to understand

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how the group that you're working with operates and makes decisions

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who's responsible for decisions.

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But but how do people make decisions under pressure

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When things are happening, your your Play books are never going

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to reflect with actually occurring because no one ever understands

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what the scenarios are going to be.

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But the more that you practice some group start to understand

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how they work together, and how they make decisions.

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And understanding that, you can always rely on technology

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to be there.

00:18:52.400 --> 00:18:55.400
So, you know, if network connectivity is not there,

00:18:55.400 --> 00:18:59.400
how do you get a hold of individuals in other ways?

00:18:59.400 --> 00:19:02.600
You know, do you have printouts of phone numbers at home?

00:19:02.600 --> 00:19:06.800
Do you know, individuals, addresses of a few people?

00:19:06.800 --> 00:19:08.700
If you had to actually drive to someone's house,

00:19:08.700 --> 00:19:13.800
do you know how to get ahold of individuals at alternative

00:19:13.800 --> 00:19:19.700
ways? Does your company have satellite phones in a few key offices?

00:19:19.700 --> 00:19:22.300
Where certain individuals can get a hold of each other,

00:19:22.300 --> 00:19:27.000
if there's major infrastructure outages depending on the size

00:19:27.000 --> 00:19:28.300
of organizations,

00:19:28.600 --> 00:19:34.600
Other ways to think of things back up out of and Communications.

00:19:34.600 --> 00:19:39.400
I think it's just a larger backup plans that organizations

00:19:39.400 --> 00:19:44.100
need to think through around larger organizational

00:19:44.100 --> 00:19:50.200
coordination and I think the other part of this is that has really

00:19:50.200 --> 00:19:53.100
changed in the last few years is well,

00:19:53.100 --> 00:19:58.000
all this is happening in, this is certainly not my area of expertise,

00:19:58.000 --> 00:20:01.900
I watch. It happen is Communications as always been a part of

00:20:01.900 --> 00:20:04.400
it, but now all of this is happening.

00:20:04.400 --> 00:20:10.100
While real-time Communications is happening around social

00:20:10.100 --> 00:20:17.600
media and other types of media being reported and it may be by

00:20:17.600 --> 00:20:20.700
your organization or other organization, so maybe people observing

00:20:20.700 --> 00:20:24.500
it and Reporting about it or it may be people in your organization

00:20:24.500 --> 00:20:29.500
reporting about it, but your organization has to Be prepared

00:20:29.500 --> 00:20:35.000
to communicate about what's occurring almost real time.

00:20:35.000 --> 00:20:40.600
Do as part of any of these plans,

00:20:40.600 --> 00:20:45.800
one of the things, you know, thinking about your communication

00:20:45.800 --> 00:20:49.600
strategy is instead of thinking in a traditional manner around,

00:20:49.600 --> 00:20:50.600
how are you doing?

00:20:50.600 --> 00:20:56.000
Press releases, or, providing structure in new daily update

00:20:56.000 --> 00:21:00.800
is almost having somebody that can provide real-time Communications

00:21:00.800 --> 00:21:02.400
out or respond.

00:21:02.400 --> 00:21:05.800
If information is coming out and it might be that you don't

00:21:05.800 --> 00:21:07.700
have updates yet because you're still investigating.

00:21:07.700 --> 00:21:12.300
But if there's information coming out, somebody needs to be able

00:21:12.300 --> 00:21:18.300
to respond to that, especially just, to control any kind of misinformation,

00:21:18.300 --> 00:21:21.900
until a situation can be controlled in a fast.

00:21:21.900 --> 00:21:27.000
And I think that, that can sometimes be most important

00:21:27.000 --> 00:21:27.700
to allow

00:21:28.700 --> 00:21:33.800
Effective response to any type of situation that might be occurring.

00:21:33.800 --> 00:21:37.400
Kristen, I was struck by what you said about the evolution

00:21:37.400 --> 00:21:43.100
from business continuity to organizational resilient and I'm

00:21:43.100 --> 00:21:45.900
wondering as we close here.

00:21:45.900 --> 00:21:48.600
If you can tell me how that we're going to say,

00:21:48.600 --> 00:21:52.300
tional resilience is reflected in the it organization

00:21:52.300 --> 00:21:59.200
and how that changes moving forward, I think it is about minimising

00:21:59.200 --> 00:22:06.300
disruption when events to occur and the ability to continue to

00:22:06.300 --> 00:22:13.300
operate through an events while still responding to that

00:22:13.300 --> 00:22:18.600
event. So, the ability to handle those situations in parallel

00:22:18.600 --> 00:22:25.100
where you've been able to perhaps defend against it or actively

00:22:25.100 --> 00:22:27.300
defended managed against it while mitigating.

00:22:28.700 --> 00:22:34.200
The effects of the situation and Dylan abling operations

00:22:34.200 --> 00:22:41.200
to continue. The ability to manage those in parallel is would

00:22:41.200 --> 00:22:42.000
I would interpret?

00:22:42.000 --> 00:22:45.800
Is that operational resilience, that ideally is occurring

00:22:45.800 --> 00:22:53.300
and that really requires that you have gotten to the level

00:22:53.300 --> 00:22:55.100
of maturity. Where are you?

00:22:55.100 --> 00:22:56.300
You have plans.

00:22:56.300 --> 00:23:01.300
They've been well tested and the robust and appropriate

00:23:01.300 --> 00:23:03.500
enough for the scenario that you're dealing with.

00:23:03.500 --> 00:23:09.900
But that you've been able to work through those in a way that

00:23:09.900 --> 00:23:15.100
you're able to respond effectively and continue to manage

00:23:15.100 --> 00:23:20.800
that well segregating out the, the operations that need to continue

00:23:20.800 --> 00:23:22.900
to maintain your business to build a

00:23:24.400 --> 00:23:27.800
Well, I run to thank you for taking the time to join us today

00:23:27.800 --> 00:23:30.700
and I wish you all the best.

00:23:30.700 --> 00:23:34.700
And again, I congratulate you on your induction into the CIO

00:23:34.700 --> 00:23:38.000
Hall of Fame and again, thank you.

00:23:38.000 --> 00:23:41.200
And I'm Julia King for CIO and idg.

00:23:41.200 --> 00:23:42.300
Thanks for joining us.

00:23:42.300 --> 00:23:43.500
Thank you.