Balancing the costs of implementing new technology & maintaining it: Q&A with Adventist Health System CMIO Dr. Shelly Nash

Shelly Nash, DO, chief medical information officer of Altamonte Springs, Fla.-based Adventist Health System's Physician Enterprise, discusses the apps and technology she finds most helpful for improving patient and physician satisfaction as well as her long-term goal as CMIO.

Responses are lightly edited for clarity and length.

Question: How has your role as CMIO evolved over the past two to three years? How have your responsibilities changed since you took on the role?

Dr. Shelly Nash: When I was hired, we were in the process of deploying an EHR and practice management system to our provider offices. In the last two to three years, we have moved to circling back and trying to optimize the workflow within the EHR that is now in place. We also have moved to focusing on reporting out of the system we now have implemented. It’s all about showing the value the system provides by allowing us to access the data to better treat our patients. My role is now very much about helping to manage populations and using technology to improve the quality of care and outcomes for our patients.

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

SN: As a CMIO, the No. 1 priority is providing value to your constituents — the providers, clinicians, staff and patients we are here to support. CMIOs are at the forefront of being able to evaluate and understand what applications or electronic tools and devices will help to improve efficiency and patient care.

You know you are successful when you're able to see improvements in your quality outcomes — [Healthcare effectiveness data and information set] or [National Quality Forum] measure scores. When your providers and staff seem more engaged and less burned out. We use survey tools to look at these and to see when your patient satisfaction scores are going up and are top decile. All of these are hard to accomplish but are what I believe all CMIOs are striving to achieve.

Q: What is the biggest challenge you're facing as CMIO? What keeps you up at night?

SN: The biggest challenge is figuring out how to use technology to improve the quality of care provided to individual patients and populations of patients without disrupting or causing a degeneration of the patient-provider relationship. We need technology that still allows physicians, nurses, all care givers, to be focused on the patient and not the computer. This is a real challenge. The number of items clinicians need to document in the patient record to meet regulatory program requirements has seemed to continually go up. Now, with CMS Administrator Seema Verma's “Patients over Paperwork” initiative, I am hopeful this will begin to change.

CMIOs need to be good stewards of resources as well. They need to balance the desire to implement new applications and technology with the costs to do this. Costs are not just implementing but also maintaining, customizing and incorporating costs to educate and train staff.

Q: Which apps and technologies do you find most helpful, and which do you think will be passing fads?

SN: Voice recognition technology, which has improved vastly over the last couple of years in the ability to understand medical terminology and regional accents, has been a great success for us. Any mobile tool that can be accessed from a phone, and not just a laptop or desktop, is a huge win as far as patient and physician satisfaction.

With all the new types of applications and technology out there — telehealth visits, asynchronous visits, patients being able to download and share their Apple health kit data with their physicians — we are really in a time of testing. Testing in that we will be able to look back and see what really led to improved outcomes, happier and healthier patients and more satisfied providers. I believe these things are the long game or goal of every CMIO.

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 jdrees@beckershealthcare.com

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