CIO eBook chronicles healthIT migration from paper to electronic record keeping
Three years ago, when we embarked on our CIO eBook, the healthcare IT world was in a different place. EHR adoption was starting to rise, enabling more complete information access electronically within the enterprise. Images were not typically available via a patient portal. They were hand-carried by the patient or sent by messenger to the referring physician. 3D studies were less prevalent, and study file size was smaller. Storage was a threat, but not a major obstacle. Cloud storage was commonplace for other industries, but not healthcare. Now look at how far we’ve come.
To understand the journey, read the eBook, “From Trust to Use and Beyond,” for a look at the major factors that have been driving clinical collaboration and change in healthcare IT. The interactive eBook takes a case study approach to the critical issues that are at the root of healthcare IT: trust, access, data, mobility, interoperability, integration and VNAs. Here’s a summary of what you’ll learn:
The issue of trust is at the heart of Chapter 1 in our CIO eBook. Clinicians are coping with change by placing trust in the things that have worked for them in the past. They know that when they spend time with patients, outcomes improve. Yet there is never enough time available. Meanwhile, adopting new procedures and a new workflow, no matter how promising the results might sound, is perceived as taking time away from patient care. So clinicians are skeptical. Chapter 1, “Building Trust”, is the story of Maureen Gaffney from Winthrop-University Hospital on Long Island, NY. She is a clinician—physician’s assistant (PA-C) and RN who has ascended to Senior Vice President Clinical Operations and Chief Medical Information Officer (CMIO). 
Ms. Gaffney’s approach to transforming her hospital was clear from the start. She began by enlisting the buy-in of senior management at the hospital, ensuring resources and transparency. Most of the actions taken on behalf of her project were guided by multidisciplinary committees which always included a clinician and an informatics specialist as members. The starting place was to ensure data integrity, coupled with an understanding of how the data would be used, and how the electronic version would fit into the clinical workflow.
Chapter 2 tells a different story—what it takes to get clinicians to change their workflow to take advantage of the benefits of electronic information access. It is based on remarks by Michael Matthews, formerly CEO of MedVirginia and now Chief Transformation Officer at Envera. Envera is a company that believes, “the only way to get to better engagement is to be honest with ourselves and with one another about what is wrong about the current state of care and what is possible to change it.” The chapter focuses on Matthews’ efforts on behalf of the MedVirginia HIE to overcome clinicians’ comfort with the status quo and current workflow. Some of the lessons learned will be valuable to anyone attempting to promote electronic access to information in a healthcare setting.
Chapter 3 is all about data—big and small. This chapter includes comments by Chris Gough (Intel) discussing big data opportunities with Steve Fischer, retired CIO of a radiology organization managing more than 100 imaging centers in 24 states. On the other side of the coin, John Showalter, M.D. from the University of Mississippi Medical Center, cautions us not to underestimate the value of basic data analysis in pointing to the identification of risk factors in hospital readmissions.
Chapter 4 is about mobility, with Ben Wilson from Intel talking about the changing technology and Woojin Kim, MD from Penn Medicine, pointing out the need to convince clinicians of the value of the new technology and its ability to access the EMR, provide secure texting, point-of-care clinical information, and patient-friendly portals for scheduling, health monitoring and e-visits.
Chapter 5 takes on the importance of interoperability and the ability of the EMR to integrate with radiology so that radiologists can use patient data to inform their clinical diagnosis and reporting. Our contributors include Cree Gaskin, MD, and Dan O’Malley from UVA, who talk about the integration between their Epic EMR, RIS and their Carestream PACS.
Chapter 6 includes the advantages of integrating payor, provider and patient data in one integrated system providing intelligent access to appropriate data to all the stakeholders—administrative level reports to managers, clinical data to clinicians, and high level reports to those who require them. The data repository they are building at HealthSpan is designed to provide additional analytic benefits from the integration of the payor, provider, and patient data.
Chapter 7 contributors include Mark Blatt, MD, retired Worldwide Medical Director at Intel, and Marco Foracchia, PhD, Medical IT Systems Manager at Santa Maria Nuova Hospital in Reggio Emilia, Italy. The planning that went into Dr. Foracchia’s VNA included an elaborate research study of more than 500 data sources from virtually every part of the hospital system. Planning to access all the data from these disparate sources greatly improved the value of the resulting VNA and its usability for all the stakeholders in their system.
Carestream’s goal with the eBook is to provide useful information on some of the ongoing issues that radiology departments, IT managers and CIOs are struggling with today. These challenges include engaging more directly in patient care, incorporating patient data into a usable format, storage issues and concepts, mobility and the ways that genetic data will impact clinical decision support of the future. The chapters are based in part on webinars sponsored with an unrestricted grant from Carestream, and facilitated by the Institute for Health Technology Transformation (IHT2). If you have a topic you’d like us to explore, please let me know at julia.weidman@carestream.com #healthIT
Julia Weidman is the Healthcare Information Solutions Marketing Manager for the U.S. and Canada at Carestream.
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