A New Era in Healthcare Delivery

Could you describe your employment history at University Hospitals, including your current position and the specific duties and responsibilities that come with it?

After completing medical school, I specialized in pediatrics and worked in that field for several years. Following that, I took a 10-year break from clinical practice to raise my children. When I returned to work, I pursued certification in clinical informatics, which coincided with implementing electronic medical records across the US. In 2009, during an economic downturn, the Obama administration passed the HITECH Act, which provided billions of dollars to incentivize hospitals, health systems, and physician practices to transition from paper to electronic medical records, which allowed me to help implement electronic medical records across the country.

I then joined Center Corporation, now known as Oracle Health, as a physician executive, where I traveled across the US to help implement this model in various hospitals. Later, in 2019, I became the Chief Medical Information Officer and Vice President of Clinical Informatics at Lake Health. When Lake Health merged with University Hospital in 2021, I became Associate CMIO, overseeing all community hospitals and independent physicians under University Hospital's umbrella.

How do you believe the healthcare sector has progressed and changed in the past few years?

Currently, I am overseeing the implementation of the EMR in multiple community hospitals within the University Hospitals system. This task is unique as each hospital has its own culture and history due to mergers and acquisitions over time. My role is to navigate and bridge these different cultures to ensure the successful integration of the electronic medical record system. This requires a thorough understanding of each hospital's individual culture and standardizing processes across the entire health system.

What are the pain points observed in the healthcare market, and what are some of the major ones currently prevalent?

The primary challenge currently faced by healthcare systems in the market is financial, largely due to the impact of the pandemic. The limited capacity to admit patients with COVID-19 has resulted in a decrease in the number of patients who can undergo surgeries and other procedures. Consequently, many healthcare systems have had to close their operations, leading to a significant reduction in revenue. Although hospitals may have been full of patients, the most profitable aspects, such as surgeries and procedures, were shut down.

A shortage of nurses has also contributed to the challenges faced by hospitals. Traveling nurses were hired at high rates, resulting in significant increases in staffing costs. Hospitals have struggled to maintain profitability as they have not generated enough revenue from operations to offset the high staffing expenses. While health systems were overwhelmed during the pandemic and received government incentives and reimbursements, these ceased in 2022. As a result, they are facing financial difficulties and laying off staff. The primary pain point remains keeping financially afloat, along with the ongoing challenge of finding personnel such as nurses.

Can you describe a project you've worked on to address pain points using new processes or trends?

The implementation of EPIC electronic health records system for hospitals and large practices aims to improve patient safety, increase revenue, attract nurses, and reduce staffing requirements. Additionally, a future initiative involves exploring remote patient monitoring with fewer staff.

The healthcare system is exploring remote monitoring solutions where one person can watch multiple patients through technology instead of having nurses physically present. Artificial intelligence is also being utilized in this area.

Artificial intelligence has been implemented in electronic medical record systems to assist physicians in their documentation process. Instead of physicians having to remember all the necessary details to document, machine learning algorithms read through the patient's data and suggest to the physician what should be included in their notes. This not only helps the physician but also ensures that the notes are more complete, which increases the likelihood of insurance reimbursement for the hospital system. The use of artificial intelligence in documentation has been presented to the industry as a way to improve healthcare systems and increase revenue.

Could you share your thoughts on the future of this industry, based on your experience and perspective, looking a couple of years ahead?

In the field of clinical informatics, technology is expected to play an even bigger role in the future. Initially, the focus was on transitioning from paper-based to electronic documentation, but now a vast amount of data is available for analysis and prediction. With the help of predictive analytics and artificial intelligence, it will be possible to determine the effects of different therapies and management approaches on patient care. Although this is still in its early stages, it has the potential to significantly improve patient outcomes in the future.

One of the areas where healthcare is evolving is the use of social determinants of health (SDH). This is particularly useful in ensuring that patients have access to healthcare services. Access to healthcare goes beyond the presence of hospitals or clinics in a patient's community. For example, a patient may have a clinic just a few miles away from their home, but if they cannot see the specialist there for another six months, then they do not have true access to care. To ensure that patients can access healthcare in their own community and environment, we need to consider social determinants of health, including the availability of specialists and primary care providers for different populations of patients. For patients with lower incomes, access to care may depend on factors such as transportation, the availability of telehealth services, and their ability to afford recommended diets. I predict that in the coming years, SDH will play an increasingly important role in healthcare, determining patient access to care and overall outcomes. This information will be crucial in providing the best care possible for patients.

What pieces of advice would you like to give to your colleagues and upcoming professionals in the healthcare field?

As a healthcare leader, it is important to prioritize SDH when providing care to patients. While financial considerations are crucial, it is equally important to consider how everyday factors impact patients' health outcomes. By understanding and addressing these factors, healthcare providers can improve patient experiences and attract more patients. Today's patients are increasingly focused on their experiences and expect healthcare providers to cater to their needs. It is no longer enough for providers to dictate how healthcare is delivered; they must also consider patients' perspectives and preferences. By doing so, healthcare providers can achieve better outcomes for their patients and organizations, both financially and otherwise.