Christus Health CMIO Dr. Sam Bagchi's biggest worry as CMIO + his plans to optimize clinical decision support

Sam Bagchi, MD, chief medical information officer and CMO at Christus Health in Irving, Texas, shares his insights on using physician performance data to improve workflows and what's next in voice recognition technology for Christus Health.

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. Sam Bagchi: Over the last three years, we have been able to shift beyond Meaningful Use to focus on clinical technology usability, clinical content governance and more thoughtful clinical decision support. Something that hasn't changed is that we are still challenged on interoperability across venues of care and between practices that use different vendors.

On a personal note, I have evolved my focus even more to quality, safety and reliability science, and have taken on a dual CMO/CMIO role.

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

SB: My top priority is to use our technology to make it easier for caregivers to do the right things for our patients. Specifically, we are focusing on optimizing clinical decision support. I don't feel any of the EMR vendors have moved far enough along in this domain, so we are piloting technology to more intuitively "nudge" physicians in the right direction on certain types of clinical intervention without disrupting workflow with any kind of binary alert. This type of technology also allows us to provide real-time physician performance data at the point of care. If we can dump every single physician report card and instead use performance data to drive improvement by embedding it within the physician workflow, I think we can improve care and the caregiving experience.

Finally, we are shifting to an "opt-in" approach to traditional decision support alerts. So many health systems have over-activated alerts, and virtually none of them change practice patterns. So instead of making the case that it's safe to inactivate a problematic nonsense alert, I am pushing to tune them all off and make the case that it's safe and effective to turn them back on one-by-one. This is a bit of a radical approach, so we aren't all the way there yet.

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

SB: Physician wellbeing is my biggest worry. It's not just EMR technology, but the healthcare industry itself that has squeezed physicians so hard that we are burning out at an unprecedented rate. The EMR channels all the regulatory and payer burden that physicians experience, so we need relief on all fronts.

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

SB: With the rapid development of voice recognition and semantic understanding/AI, we are approaching a more joyful clinician experience in some ways. Ambient listening devices for clinical encounters will transform the modern practice of medicine, and we look forward to piloting this in the next 12 to 18 months.

Also, Christus is really working hard to be good consumers and producers of virtual care services. This is much more than a technology program as we are evolving the way medicine is practiced and we look at these services as simply the next specialties we need to integrate into the care continuum.

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