Ryan Walsh, MD, vice president and chief medical information officer at The University of Texas Health Science Center in Houston, discusses his top priority as CMIO and how he uses data and connecting with colleagues to ensure success.
Responses have been lightly edited for clarity and length.
Question: How has your role as CMIO evolved over the past two to three years? How have your responsibilities changed since you took on the role?
Dr. Ryan Walsh: When I first started in informatics in 2002, the quintessential role of the CMIO was implementer and champion in chief, or, in a nutshell, change management revolving around implementing new technology. Change management is still the name of the game, but now we're more focused on how the healthcare environment is changing and incorporating technology in a more expansive way. It's our job to manage and facilitate change around process, technology and people so our clinicians can focus on what they trained for, which mostly is caring for patients. When we can't do that, we are focused on the consequences, suboptimal care and physician burnout.
Q: What do you consider your No. 1 priority as CMIO? How do you ensure you're successful?
RW: My No. 1 priority is working with our operations and clinical teams to make sure we have the right processes, technology and people in place to set our clinicians up for success. I define that success as productive, satisfied clinicians providing high quality care and still feeling like they can connect meaningfully with their patients.
Frankly, I'm not always successful. It's a high bar and a hard job. My approach is a combination of an old-fashioned ground game — visiting my colleagues while they're working, talking to them, emailing them, etc. — and using data. We started a clinician IT satisfaction survey here and recently joined the KLAS Arch Collaborative. We also look for common frustrations or complaints and try to communicate the best approach to them over a wide variety of communication channels.
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?
RW: I'm a hunt-and-peck typist. I've used some form of voice recognition software since I graduated residency, and I don't know how I'd live without it. Ask my helpdesk what happens when mine breaks.
With respect to Amazon and Google, it seems like they are very solidly into voice recognition, artificial intelligence and machine learning, but I'm not sure at what level they are infusing it into healthcare IT.
As far as having a virtual assistant in the EMR, I need to see more data, or hands-on work, regarding what the workflow looks like. For example, can my brain process dictate text and computer commands at the same time? Would a mouse click be faster? Will the technology facilitate me being away from my workstation entirely? There is definitely a place for it, and the technology is definitely exciting. It needs to be well thought out and done right or we'll wind up with the next wonder-gadget my colleagues yell at me about.
Q: Where do you see the biggest need for innovation to improve the healthcare system in the future?
RW: In my opinion, the biggest need for innovation isn't around technology but how we think about healthcare in general. The need is still around payment reform and delivery system innovation. I'd like to see the shift from volume to value continue to progress. I'd also like to see the continued progress of true population health management and prevention as opposed to disease management and sick care. This includes an increased focus on the social determinants of health. To that end, delivery systems, payers and government agencies need to be able to use an agile style framework to test new methods and models. This doesn't come with the standard National Institute of Health funded research or even necessarily Center for Medicare and Medicaid Innovation. I'd like to see more focus on practice based and community-based participatory research. I think the technology and delivery innovations will develop in those pockets. As the cliché goes, necessity is the mother of invention.
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