A picture is worth 1,000 words, even in an EHR: How U of Maryland Medical System's CIO approaches implementations

Joel Klein, MD, interim senior vice president and CIO at University of Maryland Medical System, has overseen various Epic EHR implementations, transitions and IT initiatives across the Baltimore-based health system.

Dr. Klein, an emergency medicine physician, joined UMMS in 2014 as head of IT product development. In 2017, he assumed the role of CIO and responsibility for UMMS initiatives related to Epic, applications, infrastructure and informatics.

Here, Dr. Klein discusses critical components of EHR customization and shares advice for hospitals looking to partake in the process.

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

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

Dr. Joel Klein: Within the EHR itself, we have made big investments in our physician builder program, which trains physicians and advance practice providers to customize the system on behalf of our entire provider base. This means learning all the EHR building tools and then pushing their envelopes to give providers as seamless an experience as possible.

Around the EHR, we have an advanced internal analytics development group which builds predictive models based on data from our EHR and other sources like weather, vehicle traffic patterns and claims data. We've done a good job pushing those model outputs back into our EHR so that front line staff can decide, for instance, whether the patient in front of them is more likely to get readmitted or how long this proposed surgery really will take or which of the dozens of patients in our hospital are at risk of deterioration.

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

JK: It's important to get the most out of the organization's investment. It's also critical to make users feel empowered and not completely controlled by the software. Users typically know what takes the most time. Giving them the ability to save shortcuts to decrease repetitive tasks goes a long way toward reducing burnout and improving employee satisfaction.

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

JK: There are things every team member loves, and the trick is to figure those out and connect them back to the work of the organization. One of our best developers builds furniture and other artwork; we challenged him to take the same design aesthetic when making our software more usable through visual standards. Every EHR alert in our organization must have a picture associated with that message, so when a user sees it, they visually connect it to the support idea. With the visual, clinicians are more likely to read the alert and pay attention to the advice.

Another data scientist was mostly doing reporting work about a decade ago when we got to talking about the predictive modeling contests he had enters for fun outside of work, well before machine learning or artificial intelligence were household phrases. That was the start of our data and analytics program.

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

JK: One of my most memorable moments had to do with training. We had very functional training back then, and we have since moved more to role-based. We also didn't promote practice and shadow charting and other best practices to really get users comfortable with the system before the actual go live. I vividly remember coming down to the emergency room in one of our first implementations and the staff were really struggling. The waiting room was really filling up, and I realized we just had not prepared the providers nor the nurses nor the front desk staff adequately for the transition. It got better in the next few days, but I have never forgotten how important a good training and readiness experience is to a successful transition of any type.

To participate in future Becker's Q&A, contact Jackie Drees at jdrees@beckershealthcare.com.

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