Edward Chung, MD, chief medical information officer at Tewksbury, Mass.-based Covenant Health System, explains the challenges of EHR usage for clinicians and some of the technologies he finds most helpful.
Responses are lightly edited for clarity and length.
Question: What do you consider your No. 1 priority as CMIO? How do you ensure you're successful?
Dr. Edward Chung: It's all about benefiting patient care. Always has been, and always should be.
As CMIO, I'm particularly focused on leveraging technology and informatics to benefit patient care — or at least to support those who carry it out — but patient care remains the focus for everyone on the healthcare team. If you can keep your eye on that prize, you'll usually be in pretty good shape.
Q: What is the biggest challenge you're facing as CMIO? What keeps you up at night?
EC: What keeps me up at night? EHR usage by our clinicians. And yes, that means I'm up at night a lot, but let me explain.
There are two sides to usage: proficiency, the end-user side, and usability, the vendor and build side. The former, we're trying to address by being responsive to training feedback and incorporating more workflow training and customization, re-looking at our trainers' job descriptions and asking, 'should they really be spending time resolving troubleshooting tickets?' and using EHR tools to identify re-training needs. But the latter I have relatively little control over, and this kills me.
Increasingly, EHR- and computing proficiency have become prerequisites for being able to function effectively in direct patient care. Regardless of how you feel about technology in general, I think this is a nightmare. Burnout is up, face-to-face time with patients is down, and I believe it's the work of a CMIO to try to address this situation as quickly and effectively as possible.
Q: Which apps and technologies do you find most helpful, and which do you think will be passing fads?
EC: Wearables are neat, and there are certainly some great use cases for wearable devices. The issue for me is that wearables just aren't that broadly applicable and impactful outside of those specific use cases. I'm hoping for some more generalizable developments.
Telemedicine is necessary but a bit like squeezing blood from a stone; there's a finite resource problem that telemedicine doesn't address directly. Predictive analytics, if done right, are immensely helpful and will form the basis of our value-based efforts going forward.
Q: What is the vision for your team in 2019? How will you approach your role and meeting your goals?
EC: At Covenant, we've spent basically all of 2018 in an organizationwide Epic install, for three hospitals and associated outpatient clinics, so the focus for 2019 will be shifting from implementation and stabilization to optimization and maximizing value.
We have a lot of data and tools available to us now, and we've spent a ton of resources and gone through a lot of pain to get here, so now it's time for us to extract as much value as we can. This is going to be a cultural change as much as anything, and habits like regular data review, increased transparency and heightened accountability will have to be introduced in a safe, structured way. Luckily our frontline staff and their managers are eager to get about the business of improving care, so I'm very optimistic.
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