“If You Could Tell Your CIO …”

In the first part of this blog series, I outlined the increasingly important role CMIOs are playing in the hospital ecosystem. They are bridging the gap between the world of clinical and IT, bringing a spirit of impartiality to HIT implementations that often makes the acceptance of impending workflow upsets a little bit easier to swallow.

This second part will focus on the specific challenges CMIO panelists at a recent Georgia HIMSS luncheon were particularly vocal about:

* Taking an EMR implementation from grumbles to growth;
* Data and its potential impact on establishing or refining best practices;
* Patient engagement; and
* “If You Could Tell a CIO.”

From Grumbles to Growth
All the panelists shared their “secret ingredients” for EMR implementation success. Roland Matthews, MD, physician champion at Grady, stressed that the hospital chose to implement an EMR not for the Meaningful Use incentives, but to ultimately improve quality over the long term. Despite recent EMR backlash, Matthews is a firm believer in the benefit they will ultimately bring to patient care.

That being said, he believes that simpler, easier-to-use systems are the best choice when it comes to gaining full adoption amongst clinicians. His statement echoes the increasingly loud call from clinicians for better user experience. Involving all departments in the selection and implementation process from the very beginning is also essential, according to Matthews, and serves as a testament to good leadership.

The best user experience won’t take physicians very far, however, if infrastructure is too unreliable to sport it. While he didn’t claim to speak from personal experience, Matthews also pointed out the latest and greatest EMR may never be used to its fullest potential if the platform on which it stands is down half the time.

Steve Luxenberg, MD, CMIO at Piedmont Healthcare, made sure to point out the full value of an EMR can only be realized if clinical and IT work together to maintain, optimize, and grow the product from within.

This takes us to conversation points about extracting data to create or refine best practices in an effort to drive quality initiatives.

Digging Out Data to Increase Quality
“It’s not an EMR for the sake of an EMR,” Luxenberg emphasized. “It’s about the data we can pull out, interpret and impact outcomes with.”

Daniel Wu, part-time CMIO at Grady, echoed Luxenberg’s comments: “The EMR has opened a door to allow us to collect data as we’ve never been able to do before.” The panelists all agreed on this point, and now it seems as if they are tackling the issue of interpreting the data to enable better outcomes and quality.

Matthews insisted that collecting the data is really all about quality, and suggested that the EMR should guide standards, which the panelists referred to in the same context as best practices.

Wu made the point that if providers don’t control what designates quality care, or best practices, then the government will come along and regulate it for them. (I’m fairly certain this echoes what Farzad Mostashari has tweeted about in the recent past.)

Luxenberg again emphasized the impartiality CMIOs must take when dealing with clinical and IT staff. He noted the CMIO’s role is to bring the two groups together for consensus on what best practices are and how to put those into the EMR, and added this becomes more challenging when working in a multi-facility healthcare system.

Patient Engagement
Patient portals were on the tips of all the panelists’ tongues when it came to patient engagement. Julie Hollberg, MD, CMIO at Emory, is in the middle of rolling out a portal right now. Her team is finding the most challenging part of that implementation to be educating Emory patients on what benefits the portal offers. Luxenberg was a bit lukewarm with regard to patient portals. He’s seen several come and go and has found that only a certain set of patients is apt to use them.

Wu, who has helped implement Epic’s MyChart at Grady, was firm when he said that patients have the responsibility in their court now. Patient kiosks are helping in that effort, too.

What Would You Like Your CIO to Know?
Wu’s big point was that if CMIOs and CIOs can’t communicate, each is doomed to fail. He said it with a smile, of course, as his CIO, moderator Debbie Cancilla from Grady, was standing right next to him.

Other insights included:

* Keep IT simple for the clinicians.
* Just because you can do it doesn’t mean you should.
* Always keep in mind what’s best for the patient, and what’s the simplest way to get that done.
* It’s always a good idea to have IT folks shadow clinicians and vice versa. The CMIO’s job is to help facilitate this type of partnership.

How have CMIOs brought your clinical and IT teams together? Please share anecdotes and more best practices in the comments below.