Hard ROI on health IT to be scrutinized more closely, says HIMSS23 speaker2023-04-19
Photo: Community Health Network
There’s a certain doctor in Central Indiana who is asking harder questions about how IT investments will augment care, improve outcomes and reduce the burden on clinicians. And he thinks all healthcare provider organizations today need to be asking harder questions.
That physician is Dr. Patrick McGill, executive vice president and chief transformation officer at Community Health Network. He will be presenting during the HIMSS23 session entitled “Reducing Clinician Burnout Through Decision Support That Actually Helps,” scheduled for 1 p.m. to 2 p.m., Thursday, April 20, in McCormick Center, South Building.
The session has been selected as one of ten TIGER (Technology Informatics Guiding Education Reform)-endorsed HIMSS23 educational sessions. His co-presenter is Kate Rothenberg, RN, clinical decision support manager at Community Health Network.
We interviewed McGill to discuss important trends in health IT and his session scheduled for tomorrow.
Q. As healthcare provider organization executives such as yourself gather for HIMSS23, what do you feel is the most important issue in healthcare information technology?
A. Health IT investments certainly have delivered clinical and financial value for our organization, but the current financial challenges health systems are facing have required us to reconsider our growth and operational strategy, which is changing how we evaluate IT investments.
In other words, the hard ROI any IT investment promises to deliver will be scrutinized much more closely. We’ll be asking harder questions about how the investment will augment care, improve outcomes and reduce the burden on our clinicians while also reducing the cost of care and/or increasing revenue.
IT developers are going to have to be much more concrete and transparent about the results they can deliver with their solutions and provide adequate end-user and/or clinical validation to back up those claims.
Another important issue I’m sure will be discussed heavily at HIMSS this year is the role of AI in healthcare. ChatGPT and similar generative AI tools have forced nearly every industry that creates data and text-based content to reconsider how they could streamline operations and reduce costs by incorporating such an AI tool, either on the front-end or back-end.
Of course, in healthcare delivery, our decisions directly affect our patients’ safety, health and well-being, so the stakes are much higher if we place our trust in any sort of AI solution or its outputs. In the end, though, I believe generative AI will definitely play a role in patient education and as a clinical decision support tool, considering its ability to almost instantly analyze huge amounts of data and deliver a succinct summary.
We just need to ensure there are guardrails to ensure the outputs generated are safe, accurate and relevant.
Q. What are some issues or pain points health system leaders are facing currently that your HIMSS23 educational session can help address?
A. Alert fatigue has been a significant pain point for our health system for many years and is the topic of our educational session at HIMSS23. Recently, we have made some significant progress in reducing the number of medication-related clinical decision support alerts by integrating FDB (First Databank) Targeted Medication Warnings with FDB CDS Analytics into our Epic EHR.
In 2022, for example, we identified 10 medication-related CDS alerts that were firing and being overridden most often and used FDB’s solutions to study clinicians’ responses to the CDS guidance. By learning more about why the alerts were being overridden, we were able to modify them to be more patient-specific, relevant to the immediate clinical context, and more actionable.
In just one year, medication alert volume decreased by 250,000 while the rate at which clinicians override such alerts also decreased from 92% to 76%. At the same time, the optimized alerts coincided with an increased acceptance of presented medication alerts, resulting in more than 200,000 potentially harmful medications being avoided.
Aside from patient safety, which is the most important consideration, the cost reduction associated with not administering ineffective and potentially dangerous therapies is enormous and not to be taken lightly considering the financial pressures health systems are under currently.
It’s important to have a well-planned internal infrastructure in place to support any IT solution. As we discuss in our presentation, we formed several multidisciplinary committees to establish stronger consistent governance around CDS that did not exist at this level before.
We now have a standardized and scheduled process we follow for evaluating medication-related and non-medication-related CDS guidance and continue to reduce the volume of nuisance alerts to improve the working experience and environment for our clinicians, which is more important today than ever considering the massive staffing shortages that continue to challenge healthcare.
Q. What do you think are a couple of the major health IT challenges in the year ahead for CIOs, CMIOs, CISOs and other health IT leaders at provider organizations?
A. It is a time of historic change and challenges in healthcare. Demand for care will continue to grow as more of the Baby Boomer generation reaches Medicare eligibility, yet health systems are under more pressure than ever to reduce spending as labor costs have reached unprecedented levels.
As such, C-level health system leaders are challenged by these numerous competing financial priorities and are exploring not only in-hospital solutions, but also telehealth, remote patient monitoring, hospital-at-home and other IT-enabled ways to reduce costs while still driving toward optimal outcomes and high patient satisfaction. The focus is always on technology that makes the greatest clinical and financial impact.
Health systems also are under enormous pressure to attract and retain clinicians, so I am sure many C-level leaders here at HIMSS and across healthcare are interested in IT investments that will improve clinician experience.
Our presentation is about that topic and how our health system, Community Health Network in Central Indiana, is tackling alert fatigue while improving patient safety and outcomes with smarter medication decision support.
Medication decision support has been shown to help protect patient safety and save time for clinicians, but it can paradoxically have the opposite effect when clinicians are inundated with repetitive and irrelevant alerts that are not actionable.
We have leveraged FDB Targeted Medication Warnings with FDB CDS Analytics to gain a broad, highly detailed and configurable perspective on how our clinicians were responding to medication-related CDS guidance, which accounted for 56% of alerts in the inpatient setting.
Working with FDB has helped us significantly reduce alert volume as well as how often clinicians are accepting alerts. It is a continual process, but now we have better direction, insight and tools to help us make our CDS more useful to our clinicians, who are the most important asset to any health system.
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