Fighting cancer during a pandemic

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The National Cancer Institute, like much of NIH, is teleworking. More than six months in and with the days shortening, the novelty has worn off. In a scientific organization that’s inherently collaborative with lots of laboratories and meetings, how do you prepare for the long term? Federal Drive with Tom Temin asked the NCI’s chief information officer, Jeff Shilling.

Interview transcript:

Jeff Shilling: One thing that’s really nice about working at the NIH is that you work with people who are professionals in health. So they’re not just cancer health, but mental health, because that’s where it really I think there’s a lot of concern at the NIH that we provide the services and the structure, the cultural changes that are going to be needed to manage this current situation, which basically is people working to fulfill the missions of their institutes, especially for the National Cancer Institute. One of the things that we’ve discussed is, cancer doesn’t take time off, it doesn’t stay at home for COVID. And so people are still getting cancer, they still need to be treated for cancer. And the cancer research effort needs to continue to push forward to bring in new training, promote new scientists for the grants to continue. So that means the work at the Institute, both the research that happens there, and the program work, which is what determines the granting model, how the money goes out for grants, that work has to continue. And so basically, most of that work is continuing at home. And so but that means there’s a lot of young parents and their kids are at home training, or they’re in some kind of tele-schooling, which has put enormous pressure on the staff to be able to deliver their work, but yet still exist in this home COVID thing. So the NIH has put forward a bunch of different programs for training, for wellness, they’ve tried to make scheduling be very flexible, technologically that’s doable, right. You could work any time, mostly. And so I think if we were to say, how are we working? I would say that would be my number one thing to tell you. The NIH and the NCI were functional. We’re we’re moving along. It’s just a matter of how long we can continue to do this when we weren’t designed or built do it this way.

Tom Temin: Sure. And that leads to two questions. The first one is can you measure how people are doing? Is there some indicators or metrics that generally the staff is okay from the psychological or mental standpoint? And if not, can you do anything about it directly?

Jeff Shilling: How this has been attempted, at least minimally, is through several surveys that have gone out to staff and ask them certain things about, maybe not directly their mental health, but indirectly their work capability, their situation, what they would prefer to do if they had the freedom to say, I would like to stay at home, or I’d like to come back to work. There’s a lot of concern that in the staff, and throughout the United States, that there’s a lot of safety concern for people. And so you have to mix that into just the workload thing that I mentioned — how do I stay safe? Many people live with or are very proximal to relatives that are high risk. Either children or elderly family members that they take care of at some level. And that would be a huge risk to that person if the NIH staffer, NCI staffer got sick. So I think there’s that concern as well. So while I don’t think it’s really as quantitative as we’d like it to be, say, in a trial, there is some some surveys pushed out to try to measure what you were asking.

Tom Temin: Sure. And then the other question concerns the science, because sometimes that requires laboratory facilities, and test tubes and petri dishes and so on, microscopes.

Jeff Shilling: So basically, what the NCI did, and really the NIH coordinated all this with all the Institutes. After the initial work from home word came out, the transition in March, then, right away, the institute started sorting their staff. And we said, okay, what work can be done off site, what work cannot be done off site that has to be done on site. And then the laboratory started to prepare for that. And so there was a lot of facilities management happening, and work that could never be done off site. And so there was, we call it the group zero, that was the group that never left work. So they take care of the animals, they take care of any patients in the clinical center, they take care of facilities, maybe what we would call those essential workers. And then NIH did a Group A — and Group A was the the work that could not be done and needed to be done. And it was, especially if it was COVID related, any work that COVID related came back and Group A and that group started working right away in the laboratories in the clinical setting. And then we also have a Group B, and now Group B too. And so the NIH has about 3,000 staff that are coming back to work, doing the laboratory work that you mentioned, work that cannot be done off site. And that’s all managed through a complex social distancing and mask wearing and set of testing that’s available for the staff. And the count of any COVID positive has been very, very low. So it’s considered very successful to be able to do the work that you mentioned, as much as we possibly can at the facilities, and yet still maintain the safety that’s required.

Tom Temin: Let’s switch gears here for a moment and talk about the technology. All the agencies, presume including NIH and NCI, had to make sure they had enough virtual private network connections, and invest in all of that. But as time goes on, a lot of CIOs are looking at more sustainable and less expensive options for supporting lots of people teleworking. What is your technical status?

Jeff Shilling: I think we’ve benefited from network modernization that was put in a few years ago, we had just expanded the VPN capability, we moved to Office 365 tenants so that we were running a lot of our business in the cloud. And so I would say we really didn’t skip a beat. If we look at our dashboard, our daily COVID dashboard, the IT is the only green thing on the list, and has been that way for a long time. And so I will say that it’s not without luck, right. But it is because of a lot of planning that’s put in on the IT side. It’s also I think that when you go through the coop exercises, the continuity of operations planning, the IT takes that very seriously. And we run through certain scenarios. And because of that, I think we were very prepared for this situation. Again, there was definitely luck involved. For example, there were things that out of our control that happened to work out, like everybody at home has an internet connection, nearly everyone at home has an internet connection, that has the bandwidth to be able to do teleconferencing, video teleconferencing. If you go back in time, there’s nothing NIH could have done if we were 10 years ago and this happened, right, nobody would have that bandwidth to be able to do that, that technology wouldn’t even be available. We’re able to ride on the coattails of the Netflix and the type of high streaming that the internet is now built for in the United States that we can then utilize, so people can be at home and you can have two or three or four people on the internet doing work with really not missing a beat. So I think that and along with the things moving to the cloud, capabilities moving to the cloud, that puts a lot less stress on that one connection coming into NIH. I think the other thing that’s worth noting is that the NIH is a research organization. And as such, it does two things. It does research at NIH itself, what’s generally called the intramural or inside the walls program, and then it does the extramural, or the granting. And so most of the money, probably 66% of the funding, 70% of the funding goes out to organizations. So as such, we really have this kind of remote understanding of how we work. I know one of the things we want to discuss today was, how is it working with the grants organization? How is it working with the lab partners and medical institutions? And those were really, really remote already. In fact, if you ask me, in fact, the director made a comment the other day saying that we have our national cancer advisory board and that group has been meeting remotely via WebEx and a couple other technologies that we use. And the director made a comment saying, I think we’re now all very, very comfortable running these meetings with WebEx, meaning that staff are following along, they’re able to interject when they need to, the meetings are recorded, so people can watch them later. All these little things. So I think the transition will help us in the long run, even when we get out of this COVID situation, because traveling all those people in is expensive for the Institute. But it’s also expensive for those staff because they have to take all that time to travel. So being able to efficiently do these meetings and have these discussions remotely, I think will be much, much better in the long run because it’ll just enhance the collaborative nature that science requires.

Tom Temin: Just a final question, are you looking at virtual desktop infrastructure or ways to get away from the VPN and that kind of networking, or pretty much now that things seem to be settled in and people have the bandwidth for the video conferencing, etc. — leave well enough alone and just go with what you’ve got?

Jeff Shilling: I will say we’re always looking at new technology. Often new technology is not a magic bullet. It’s not a perfect fit. But if you wait too long for it to be a perfect fit, you’ve maybe missed out some of the preparedness that you need when you need it. So we are looking at virtual desktops. A lot of the situations we have is around security. And so in order to work with the staff that we need to work with, not all of them can be brought into the NIH community. Not all of them can get a PIV card and go through security. Sometimes they’re not any even in the United States, the scientists were working with the laboratories, right. Disease is a worldwide thing. And so is healthcare. And so there’s a lot of capabilities throughout the world. But we can’t get those people a PIV card. We would have to travel them in to do that. And so we’re looking at some of these remote technologies, not just for our staff, but really to say, well what is an NIH staff? What is an NIH collaborator? And how do we get them securely connect to the resources that they need to connect to so that we can make sure that they are who they say they are, when they connect, we know that everything is done securely through encrypted connections. And so we’re really excited about VDI for some of those use cases. Most of our staff though we will continue to provide laptops for them. And we’ve been able to do all that remotely. And really, through innovations, that the world has provided, that the IT world has provided for Windows and Mac and Unix computers, we can pretty much do that all remotely. So I think the scientists and the administrators at the NIH, they need computers, and using VDI full time would be very, very difficult for them. But we do feel there’s a lot of collaborators that are only occasionally working with NIH and could use VDI. And the other thing I wanted to add was that moving our workloads to the cloud, that is something that we’ve been working on. And again, it maybe wasn’t ready for primetime, it didn’t really make financial sense to always do that. But having that capability and having those cloud capability available to us means that we can now move a lot of work to the cloud so we don’t have to have these connections from outside places coming into the NIH proper. We can have them coming into the cloud solutions– and that makes the networking congestion a lot more doable, make security doable. And it really makes the content sharing and collaboration, which is really what we want, it just makes it kind of capable rather than an add on.

Tom Temin: And there’s always the issue too that the congestion on Rockville Pike is diminished because of so many people from NIH teleworking and I think the county thank you for that.

Jeff Shilling: Greatly. Ever since the Navy medical was merged with a Walter Reed. and now it’s the Walter Reed Hospital there, there’s a lot of traffic there and there’s a lot of veterans that go to that service — and I know there was planning done to make that as good as possible, but it’s still a very, very busy place. So I agree. The whole county, the whole DC areas traffic is a lot lighter. So that is one advantage if you do need to get around.

Tom Temin: Well, I’ve always proposed a flyover bridge for both campuses, but I don’t think that’s in the cards right now in this budget environment.

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