Christopher Longhurst, MD, MS, CIO and associate chief medical officer of quality and patient safety at UC San Diego Health, discusses increased patient access to the health system and why EHRs aren't the primary cause of physician burnout.
Responses are lightly edited for clarity and length.
Question: How do you promote innovation within your organization?
Dr. Christopher Longhurst: Innovation is woven into the fabric of academic medical centers like UC San Diego Health, and bringing the right people together to collaborate on disruptive ideas is key. We are well positioned locally with leaders, like our Chief of Innovation and Transformation Matthew Jenusaitis, to explore a variety of opportunities within our industry and peer health systems across the University of California. These partnerships allow us to explore new technologies and processes that improve patient care.
Within UC San Diego Health, we have put together a clinical informatics team led by Chief Medical Information Officer Brian Clay, MD, and Clinical Research Information Officer Mike Hogarth, MD, to innovate in our clinical and research areas. Finally, our AMC is the perfect setting for our annual health-focused hackathon, which brings together a multidisciplinary group of experts and students to co-create solutions that address critical issues in healthcare today.
Q: What is one thing you've learned about your patient population that's really surprised you?
CL: How eager patients are to participate and be fully engaged in their own healthcare. Data from our EHR system has shown that our patients access the system more often every week and every month than our own staff and providers. Patients are an underutilized resource in healthcare today. An emphasis on transparency and access, enabled by health IT, is critical to helping patients take charge of their own health.
For example, we rolled out our Open Notes initiative to provide patients in our ambulatory settings with their provider's visit notes. The initiative, led by Marlene Millen, MD, CMIO of ambulatory and practice affiliations at UC San Diego Health, allows patients to make informed decisions and have better discussions about their healthcare.
To address access, our MyUCSDChart app helps anyone who downloads it to find urgent or express care locations with walk-in access and use our 'Save My Spot' feature at these locations. UC San Diego Health patients can also use the app to communicate with their care team, view test results — including all radiology results — manage prescriptions, view and pay bills and schedule different appointments and screenings, including annual mammograms.
Q: What is the most exciting thing happening in health IT right now? And what is the most overrated health IT trend?
CL: Focusing less on specific technologies and more on the democratization of health data through user-friendly analytics makes this an exciting time for health IT. We have the opportunity now to leverage the clinical data from EHRs to create a learning health system that truly personalizes care. EHRs have the data to help us quickly pinpoint an optimal course of care for an individual patient in the absence of published, peer-reviewed literature. From a population health standpoint, analyzing health data also represents an opportunity to enable quality improvement across the healthcare system.
Q: What's one conviction in health care that needs to be challenged?
CL: We have to challenge the prevailing notion in the medical community that EHRs are the primary source of physician burnout. In fact, based on a comparison of international and domestic healthcare facilities using the same EHR vendor, my colleagues and I observed that physicians abroad are more satisfied with their EHR and have seen greater gains in efficiency. One reason for this discrepancy is less burdensome regulatory and billing requirements for documentation in other countries. Minimizing unnecessary documentation with national policy changes, allowing patients to contribute to their physicians' notes and focusing on optimizing and individualizing workflows using the EHR may be part of this solution.
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