Asante CMIO Dr. Lee Milligan's top priority for 2019 + the biggest need for innovation in healthcare delivery

Lee Milligan, MD, chief medical information officer at Medford, Ore.-based Asante, discusses prioritizing self-service and efficiency of data analytics and how voice recognition software can help improve the EHR.

Responses are lightly edited for clarity and length.

Question: What do you consider your No. 1 priority as CMIO? How do you ensure you're successful?

Dr. Lee Milligan: Being confident in our own provider data. When I put individual performance data in front of physicians, I am putting my own reputation on the line. Population health demands strict attention to performance metrics around both quality and financial stewardship. I need to know two things about this data before doing so: What is our objective quality rating of this data? And is this data fit for business use?

If our quality rating is low or if the data is not fit for business use, then I will do everything in my power to keep it from seeing the light of day. It's not fair to either the physician or the health system. As for being fit for business use, our enterprise data governance program has set the framework for ensuring data quality success. It provides accountability around data quality, proper use and movement.

Q: How did you become a CMIO? What is your background and what advice do you have for aspiring CMIOs?

LM: After practicing emergency medicine for nine years, I went back to college to pursue computer science. My wife was like, "honey, what the heck are you doing?" but she ultimately fully supported my efforts. I became a credentialed trainer and then a physician builder in our instance of the EHR. I then built production-ready EHR pieces, such as order sets, [best practice alerts] and reports with print groups, for two years. This led to a deep understanding of EHR workflow analysis, training, design, build and change management.

I also became certified in the [Oregon Health & Science University] 10x10 course, Introduction to BioMedical Informatics, taught by Bill Hersh. I then pursued board certification in clinical informatics, becoming board-certified in 2018. At the same time, I was asked to serve on several governing boards: our health system board, medical group board and ACO board. The combination of high-level strategic planning experience on boards and the granular EHR build made for a powerful combination in meetings.

Q: What is the vision for your team in 2019? How will you approach your role and meeting your goals?

LM: In 2019, on the analytics front, we plan to focus on two priorities: self-service and efficiency.

As for self-service, locally we are calling this "data-on-demand" and consists of a variety of tools that key users, from different operational departments, are leveraging — Reporting Workbench, Webi, Slicer-Dicer and Tableau.

Regarding efficiency, we have organized our analytics team into four functional units, each working in three-week Agile sprints. We plan to double-down on our lean methodology. This will include performing, for the first time, "Analytics on our Analytics."

Q: Where do you see the biggest need for innovation to improve the healthcare system in the future?

LM: Voice Recognition. To date, voice-recognition has allowed providers to document individual notes but has not contributed to meaningful navigation of the EHR. I am concerned that the leading companies in this field are attempting to skip over this step with the introduction of Alexa [Amazon]-related listening in the patient room. Physicians are telling me that they need the ability to oversee the specific narrative around the patient history; they are not looking for a tool that records everything.

Physicians are asking for voice functionality that supports commands — allowing for seamless navigation of the EHR. For example, if the provider could command the EHR to pull up the last three CT scans of a patient in reverse chronological order or list the last five [comprehensive metabolic panel 14's]to visualize a trend in renal function. This level of voice-recognition navigation is the game changer we have been waiting for.

To learn more about clinical informatics and health IT, register for the Becker's Hospital Review 2nd Annual Health IT + Clinical Leadership Conference May 2-4, 2019 in Chicago. Click here to learn more and register.

To participate in future Becker's Q&As, contact Jackie Drees at

More articles on health IT:
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Facebook's head of health research says physicians need more personal patient data
Lehigh Valley Heath Network CMIO Dr. Donald Levick: Biggest challenge & top priority in the role

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