Christopher Maiona, MD, CMO at EHR optimization software company PatientKeeper in Waltham, Mass., discusses his EHR concerns and their correlation to physician burnout rates as well as voice recognition technology and the potential improvements it poses to clinical decision support and physician workflow.
Responses have been lightly edited for clarity and length.
Question: Where do you see the biggest need for innovation to improve the healthcare system in the future?
Dr. Christopher Maiona: Innovation is required to make computers indispensable tools for patient care. While we have done a reasonable job in some areas — data capture, clinical decision support and document legibility, for example — we have not made the EHR indispensable for the nurses and doctors at the tip of the patient care spear. To the contrary, we have complicated workflows, fractionated thought process, decreased productivity and demoralized users, as evidenced by the alarming physician burnout rates attributed in part to EHR concerns.
The innovation I believe we need, in the near term, relates to EHR optimization — specifically, creating an instinctive user experience for physicians and enhanced integrations with third-party applications, platforms and the health information exchange. These integrations will provide the clinician with a 360-degree view of the patient in a manner consistent with a provider's thought process, specialty and patient diagnosis. This EHR optimization will provide the foundation for further innovation as we look long term to integrating with more advanced technologies as they become reality.
Q: What do you consider your No. 1 priority as CMO? How do you ensure you're successful?
CM: One of the roles of a CMO in the health IT space is to level set the wants and needs of the clinical end user with the technological capabilities and vision of the technology vendor. In this role as peer liaison and translator, my primary priority is communication. As such, my job entails perpetual conversation. I listen to my physician colleagues to ensure we are providing them with what they need to safely practice at the top of their game. I draw on this input, as well as my experience as a physician, to help guide development and implementation of software that provides maximum value and an optimal user experience to our physician clients.
Q: How do you feel about the use of voice recognition technology, such as Amazon’s Alexa and Google Assistant, in healthcare? Is there a place for its use within the EHR?
CM: There is definitely a place for voice recognition technology in the EHR. One of the major challenges physicians face with the EHR now is the inability to rapidly translate thought into action. While certainly lacking the clinical decision support and legibility of modern systems, the paper chart supported the direct link of pen to paper — I did not have to click my pen 20 times before writing an order. Voice recognition technology can affect this direct link, whether it be for simple screen navigation, note dictation or complex order entry and diagnostic research, immediately as the thought is conceptualized. The result is an instinctive process that maintains the physician's train of thought, enhances patient safety and empowers physicians to be better.
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