Keeping Pace With Healthcare

Linda H. Butler, VP of Medical Affairs/CMO/CMIO, Rex Healthcare
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Linda H. Butler, VP of Medical Affairs/CMO/CMIO, Rex Healthcare

Challenges in technology to meet enterprise needs in 2013 and expectations

There are many integration challenges, but the most frustrating challenge is having massive amounts of data that is not actionable or useful as information. My overall wish is for systems to exchange data or interface with ease. That is like asking for world peace! We need technology to keep pace with the rapidly changing healthcare landscape so that we can meet all the reporting requirements and manage patient populations more effectively.

The areas in business environment where solutions do not yet exist or not up to the mark, and which if existed, would've made job easier

The one challenge that will affect physicians in 2014 is the granular documentation requirements of ICD-10. There is progress being made with front-end voice recognition systems that help prompt physicians to be more specific in their documentation by using NLP or NLU. The beauty of these systems is that the prompt occurs while the physician is in the normal workflow of dictating. These systems need to address the ICD-10 documentation needs to make both the clinical documentation specialists and the physicians more efficient.What concerns me most is finding the correct balance between decision support prompts/alerts that improve patient safety and the prevention of alert fatigue that results from numerous pop-ups in the EMR.

Manner in which data is used to head off problems and complications before they happen

We have recently signed an agreement with North Carolina State University to collaborate with them via their schools of business, engineering, and analytics. We hope to use their expertise to develop predictive analytics that is institution specific and will also improve our efficiency and lower cost. The use of natural language processing will help clean information from documents that are rich in details but are free text and would previously have required manual abstraction to extract data. The electronic health record should make reporting easier; however, creating reports requires clinicians to consistently enter data in defined fields. Empty fields will create an unreliable or useless dashboard.

Thoughts on how IT strategic planning supports organization- wide efforts to improve quality, cut costs and improve efficiency in the Healthcare sector
We decide upon corporate goals annually that are based on five levers of excellence. Technology is one of those levers. We make sure that all the levers are aligned. We have a quality close meeting that occurs monthly. We discuss the corporate quality goals, core measures; value based purchasing scores, etc. The IT team has a representative attend, because the EMR has been instrumental in achieving our quality goals/ targets.

My roles and responsibilities as a CIO

I can at least address the changing role of the CMIO. I have only had this responsibility for the last couple of years. I have been the VPMA/CMO for over 4 years. I was willing to take on the CMIO responsibilities because of how instrumental IT and the EHR is to achieving our quality goals. Clinicians use the EMR extensively and it can impact their experience at the hospital in a positive way when they are involved in the implementation and optimization of the system.

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