Geisinger CMIO: Innovation is about finding new ways to problem solve, not using new tech 

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Benjamin Hohmuth, MD, chief medical informatics officer at Danville, Pa.-based Geisinger Health System, sees innovation as new ways to tackle relevant problems rather than an opportunity to deploy new technology.

Dr. Hohmuth has a special interest in clinical informatics and has served as CMIO at Geisinger since 2018. Prior to taking on the role, he was associate CMIO and director of the health system's hospital medicine department.

Here, Dr. Hohmuth discusses how he helps foster innovation among his team members as well as the customization his team applied to improve workflows in Geisinger's EHR.

Editor's Note: Responses have been lightly edited for clarity and length.

Question: How do you promote innovation among your team members?

Dr. Benjamin Hohmuth: Think about innovation as new ways to solve problems. Our goal is not to use new technology but rather to solve relevant problems. If new technology can help, that is great, but that is not always the case. Using existing tools in a thoughtful way with careful attention to workflow can sometimes be quite innovative and have a significant impact.

Q: What is one recent initiative you've taken to customize your EHR system?

BH: We've developed a custom solution to aggregate both internal and external data to inform care. We identify both unrecognized chronic conditions and care gaps and can present some key actionable elements within our native EHR workflow. Allowing our providers to act on external data without even realizing they are outside our EHR has been a huge win.

Q: What advice do you have for other hospitals looking to implement an EHR customization?

BH: Skate to the where the puck is going. Most of the problems that drive custom solutions are not unique to one organization, and the EHR vendors are often developing solutions that may be better and cheaper than maintaining customizations. We frequently need to implement solutions that aren't yet available from our vendor, but when we develop customizations we do so with a good understanding of where our vendor is heading in this space. This allows us to make build and workflow decisions that may make it easier to cut over to the vendor solution when the time is right.

Q: What has been one of your most memorable moments as CMIO?

BH: One thing that can't be overemphasized is how frequently good ideas can fail when they hit clinical workflow. Often this is due to poor usability resulting from inadequate involvement of the end users in clarifying the problem and developing the solution. 

We've had several examples where slight adjustments to how a tool intersects with workflow led to massive increases in adoption and positive impacts to our patients. For example, we developed a robust custom approach to delivering rapid care to sepsis patients. The initial workflow to trigger this did not mesh seamlessly with native workflows and adoption was poor. However, after some workflow analysis and additional end user input, we were able to make some slight adjustments that quadrupled appropriate use overnight.

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