Vinay Vaidya, MD, is vice president and CMIO of Phoenix Children's Hospital.
Here he discusses where Phoenix Children's has made the biggest technology investments and what he sees as the best opportunities for the future.
Question: What is the best technology investment the health system has made in the past year?
Dr. Vinay Vaidya: Definitely one of the best technology investments we made was in our clinical documentation system and report dashboards across all of our ambulatory clinics. Since implementing this technology, our clinicians capture about 99 percent of their chart notes in a structured format, as opposed to free text, which has reduced medical transcription costs in our clinics and made EHR content more searchable and computable. We are saving about $1 million a year from the elimination of transcription, and our documentation enhancements have increased physician productivity and patient care. We are also able to make our clinical data easily assessible for analytics and decision support, which has enhanced our management of patients with chronic disease.
Q: How do you approach EHR implementation and interoperability within the system? What is your strategy for connecting inpatient and outpatient settings?
VV: Our inpatient and outpatient EMRs are from the same vendor (Allscripts), which facilitates the sharing of clinical information across care settings.
Our approach to the implementation of our EHR and clinical documentation improvement system followed a well-planned and well-executed process that started with several months of formal meetings with physicians and the IT team, even before the actual product was selected. After a full assessment of the clinicians' needs in our inpatient and outpatient settings, we identified the best solution for our needs (Medicomp Systems’ Quippe) and began a well-governed process to roll it out by specialty group. Clinical usability was a high priority, as was making sure clinicians could easily capture clinical information that addresses each department's specific documentation requirements, as well as our analytics, reporting and quality-of-care initiatives.
Before the IT team met with each department’s physicians, staff reviewed dictated notes, billing data and current medical literature to better understand each specialty’s unique needs. By investing time and resources prior to meeting face-to-face, the IT team made the best use of the doctors' time and gained their buy-in, building the foundation for strong IT/clinician collaboration. It was critical for us that the implementation of our technology be accessible and easy to use across all care settings, inpatient and outpatient, and all departments. With such a large investment, we wanted physicians to treat patients and deliver the best outcomes with the relevant information they needed at the point of care.
Each department met with the IT team four to six times over a seven- to 10-week period. IT continuously queried physicians about their needs and challenges and identified what measures required tracking. Staff updated templates between meetings and then collaborated with physicians again to fine-tune the templates. In the end, each department had robust, comprehensive custom-built, clinically dynamic templates, as well as engaged physicians who recognized the new tools would facilitate better patient care.
Q: Where do you see the biggest opportunity to improve the patient experience with IT?
VV: The biggest opportunity is for physicians to have access to a complete picture of the patient at the point of care. Often data is dispersed across various technologies within a hospital or health system; or if it’s within one platform, it lies across several screens and is difficult to find.
During our IT implementations, we were intent to deploy the platforms in a way where they would aid our physicians instead of becoming a roadblock in the patient's treatment plan. To do this we ensured that our EHR and clinical documentation systems were built in a way that gave physicians the patient information they needed, when they needed it, while reducing the amount of screen time and clicks during an encounter.
The more time physicians spend face-to-face, caring for patients — and the less time spent caring for the EHR — the better the healthcare experience will be for everyone.
Q: How do you think Amazon, Apple and Google will change healthcare? Is disruption possible?
VV: My view is that of cautious optimism. The optimism stems from the rapid pace of disruption and innovation that information technology has made possible in the last decade, in almost every field. I have no doubt that technology will play a pivotal role in the coming decade, more specifically through data-driven improvements such as big data, machine learning, AI, and other technologies that are transforming healthcare as we know it today. However, healthcare is a much more complex ecosystem, with many more moving parts than most other industries. This requires a thoughtful, deliberate, and iterative approach to innovation, rather than a magical belief that simply 'Uberization' of healthcare or the next Apple watch or Google glasses could be the magic bullet that will disrupt and transform healthcare.