Mike Minear brings more than 40 years of experience in health information technology to his role as senior vice president and CIO at Lehigh Valley Health Network in Allentown, Pa.
As CIO, a position he has held since 2015, Mr. Minear oversees information and clinical technology for LVHN. He also serves as a part-time associate faculty member for Johns Hopkins University Bloomberg School of Public Health in Baltimore.
Mr. Minear is a member of the first group of healthcare executives in the U.S. to be credentialed as a certified healthcare CIO by the College of Healthcare Information Management Executives. He is also a member of the Healthcare Information and Management Systems Society.
Here, Mr. Minear discusses his approach to innovation at the health system and why it is important to build a foundation on problem solving.
Editor's Note: Responses have been lightly edited for clarity and length.
Question: How do you promote innovation among your team members?
Mike Minear: Some people or teams try to innovate but focus more on interesting new technologies, what we often refer to as bright shiny objects, without a sense of what the technology can be or should be used for. Real innovation occurs when a team is brought together to solve a real-world problem. The more diverse the skills, perspectives and experience, the better the team will be at problem solving. The more important or acute the problem is, the better chance real innovation will occur.
Effective or valuable innovation can sometimes be simple, such as thoughtful changes in workflow or retraining people doing the work. Other types of innovations are very complex, as required to truly change the status quo to achieve real measurable change.
As LVHN created clinical pathways, some of these projects involved material changes to clinical workflow, changes in clinical orders, new types of clinical interventions, training of hundreds of clinicians and often reduced time to response or act within clinical workflows. LVHN has seen these types of innovation projects improve metrics in a dramatic way, and just as important, the changes stick and show ongoing improvement over time versus sliding back to older habits or performance levels. This is the innovation worth investing in.
Q: What has been one of your most memorable moments as CIO?
MM: Helping to set up teams doing real innovation, supporting them as they slog through the hard work of innovation and seeing them achieve real improvements that impact our patients. I call this magic, and when it happens it is very gratifying to see.
Q: How do you approach EHR customization?
MM: We don't really customize a modern EHR, but we do create and edit online clinical knowledge linked to the EHR as part of creating change. At LVHN, we focus on 12 types of knowledge as the foundation to both manage clinical care/workflow and innovate.
Knowledge that is created and managed by LVHN includes; order sets, drug formulary, documentation templates, rules and alerts, clinical pathways, oncology treatment and therapy plans, cognitive computing or artificial intelligence models from Epic or self-created.
Knowledge that LVHN licenses from vendor partners includes; medication knowledge bases including pharmacogenomics from First Data Bank, online drug monographs from Lexi-Comp, care plan knowledge bases from Elsevier, patient teaching content from Elsevier, and clinical terminology from Intelligent Medical Objects.
Q: What is one recent initiative you've taken to enhance your EHR system?
MM: LVHN's recent innovation priority has been to build 50 clinical pathways in the Epic EHR leveraging many types of online knowledge. In addition to clinical data in Epic, we use claims and insurance data from our Populytics subsidiary using Optum software tools, cost from a McKesson application and build a customized Tableau business analytics model for each clinical pathway.
The LVHN pathways have been very successful in creating focused innovation across many clinical issues. Examples of key metrics used in pathways include length of stay, re-admission rates, best practice-based order set compliance, internal cost of care, claims data — also showing care provided outside of LVHN such as in post-acute settings — and payer metrics such as percent of fee for service vs. value/risk payer contracts.
Q: What advice do you have for other hospitals looking to implement an EHR customization?
MM: Spend time and money attacking real and material problems. Ensure you have a solid definition of the problem you are trying to address and ensure the scope of the problem is thoughtful and optimal versus trying to boil the ocean.
First, create a learning case where a high priority problem or challenge is identified, define a team with key people with different and relevant skills, and support the team until the problem is resolved. Assess this effort and refine how your organization will set up and operationalize change teams. Take the time to support and train other change teams in what you now know works for your organization. In other words, take the time to learn how to affect real change versus assuming people know how to do this and be successful.
To participate in future Becker's Q&As, contact Jackie Drees at jdrees@beckershealthcare.com.