How Intermountain's chief health information officer tackles innovation, customization

Diego Ize-Ludlow, MD, chief health information officer of Intermountain Healthcare, has spearheaded the Salt Lake City-based health system's efforts to add customized decision support tools to improve workflows within its EHR.

Prior to joining Intermountain in 2016, Dr. Ize-Ludlow served as associate chief health information officer at Chicago-based University of Illinois Hospital and Health Sciences System and chief of pediatric oncology at University of Illinois Chicago.

Here, Dr. Ize-Ludlow discusses Intermountain's EHR customization efforts and why it's important to have a plan in place to evaluate new additions.

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. Diego Ize-Ludlow: We started using customized decision support tools to assist the implementation of specific leverage points for evidence-based best practices. We also use a combination of technical solutions, continuous improvement principles and implementation science practices to more quickly and reliably integrate best practice care steps into clinical workflows. For this approach, we follow core components, including identifying high-value opportunities.

Next, we engage front-line teams responsible for care delivery and empower them to carry out frequent improvement initiatives. In some cases, the improvement intervention implemented is a technical solution embedded in the EHR. For example, to better help emergency room providers care for children after minor head trauma, we integrated an ordering tool that reminds providers of evidence-based risk stratification criteria and recommended monitoring practices by risk level. Recommended orders can be placed directly from the tool. We measured adherence to the recommendations before and after implementing the tool.

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

DL: Evaluate the total cost of ownership of customizations. Develop  a plan to measure the impact of the customization and have a path in place to remove the customizations that do not bring high value.

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

DL: We are explicitly delineating the focus of our teams. Some of them focused on sustaining innovations in the acute and specialty-based care and others focus on disruptive innovation in community-based care. We are intentionally decreasing resource dependency across acute and specialty care and fostering small wins and smart failures in community-based car. This allows for the progress of the disruptive technologies that will continue the rapid evolution of the value-based business model.

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