I was going through some recorded audio clips and I know I have yet to craft the second part of my discussion about IT challenges in the hospital setting with Dr. Justin Graham. I wished I had recorded it on video instead, but listening to audio clips while on the road can be pretty productive, too.
I hope you enjoy listening in to the conversations.
The moderator and list of panelists below:
Justin Graham, MD MS, then Chief Medical Information Officer at NorthBay Health System and now Chief Innovation Officer at Healthcare at Hearst Business Media
Rajiv Pramanik CMIO at Contra Costa County Health Services
Mike Aratow CMIO at San Mateo Medical Center
Jenson Wong CMIO at San Francisco General Hospital
Transcription of the first half of the discussion below:
Justin: Completing Meaningful Use stage 1 roll out (outpatient) and gearing up for Stage 2, and ICD10 hanging in our heads, business analytics, preparing for ACA, retooling our health records, trying to improve our quality score, improve patient satisfactory scores, with less and less money, and smaller reimbursements coming up.
Rajiv: Last year 2012, we went big bang with Epic. Challenges we face then and which we continue to face are — clinical users and their ideas of what’s a bug and what’s a preference. That’s kind of where it gets personal. In one of our leadership seminars, one of the ladies takes me aside and says, ‘This thing sucks. We have this thing call in baskets. I’ve been getting a 100 messages a day and have no idea what to do with them. I have never used them before. I’m not going to use them at all.’ Someone else goes and says, but I like that. Different representations and opinions. Physician goes to IT and says ‘This is a bug, change it.’
We’ve developed a structure called a Trio, comprised of an analyst, IT person, and a physician / clinician / nurse personnel to try to decrease this chasm between IT and the clinical structure to have more rapid improvement in our IT innovations.
Mike: Data integration. Training physicians. Incentives and disincentives. There is a challenge to get even people trained.
Jenson: Small crew of informatics personnel with a lot of things needed to be done. Biggest issue: governance.
We’ve heard a lot about great technology here at the forum. Say one of the companies we heard today, like a Big Data analytics provider, comes to you and says, we are the right solution for your organization and we’reready to go, what’s the next step and how do you respond to that? What’s next?
Mike: We can turn things a little more quickly. We don’t go into so much levels and people. We listen to the pitch. We can work with you but it has to be no cost to us. Or that there’s minimal human resources involved, or it’s something aligned with our strategic goals, helps us save money, creates efficiencies and ROI.
Jenson: When people come to us with ideas, they need to go through the bureaucracy of city government. Things come in through the back door through UCSF — then things happen more smoothly. Most of the time, things stop at the bureaucracy part.
Justin: We have our share of our bureaucracy too, even if we’re small. But we do have loose governance, and our CEO steps back from decision making. Get buy in from stakeholders unanimously.