Why EHR customization should be kept to a minimum: Providence St. Joseph Health CMIO

As senior vice president and chief medical information officer at Providence St. Joseph Health, Michael Marino, DO, leads the Irvine, Calif.-based health system's clinical informatics department and system wide optimization efforts.

Dr. Marino first became associated with Providence St. Joseph Health in 1997 as a practicing pediatrician and member of the St. Jude Heritage Medical Group physician leadership team. He went on to serve as CMO at St. Jude Medical Center in Fullerton, Calif., before assuming the role of CMIO at Providence St. Joseph Health in 2012.

Dr. Marino earned his DO degree from Pomona, Calif.-based Western University of Health Sciences and his MBA at University of Massachusetts Isenberg School of Management in Amherst. He is board certified in pediatrics and clinical informatics.  

Here, Dr. Marino discusses Providence St. Joseph Health's approach toward EHR customization and innovation among team members.  

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. Michael Marino: It is well established that checklists can be an invaluable tool to drive standards of care, especially in high risk conditions like, sepsis, stroke and myocardial infarction. Our EHR didn't have a robust, interdisciplinary tool that could be used to track patient progress and ensure all the correct steps were happening in the required timeframe and order. So, we built a customized tool that is embedded in our EHR, which is visible across the continuum of care and owned by the entire care team.

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

MM: True customization should be kept to a minimum in most EHRs. Customizations are difficult to maintain and potentially can break or require extra care with each upgrade to the software. However, when they improve patient care or the caregiver experience, they usually are well worth the work.

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

MM: In large healthcare organizations, promoting innovation can be difficult. Team members too often can be head down in just keeping up with the work on projects at 'scale' or worse, ending up as 'ticket takers.' We are putting together a program to have our internal experts start to focus on what we are calling 'simplification,' looking for easier, more efficient ways of doing the work and not relying on the philosophy that this is the way it always has been done.

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

MM: I have worked in this space one way or another for 25 years. For me, what is most memorable is not a single moment but the slowly increasing ground swell of opportunity in the health information technology space. With true mobility options, voice recognition, artificial intelligence and machine learning, large IT companies, not just EHR vendors, are working to help move healthcare forward. We are seeing true excitement in this potential from our frontline nurses and physicians.

To participate in future Q&As, contact Jackie Drees at jdrees@beckershealthcare.com.

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