How Johns Hopkins boosted data sharing between patients, clinicians: CMIO Dr. Peter Greene

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Peter Schuyler Greene, MD, brings more than 20 years of information technology experience to his role as chief medical information officer of Johns Hopkins Medicine in Baltimore.

Dr. Greene has a wide range of expertise in topics related to healthcare informatics, educational technologies and data analytics for research and quality. In addition to his role as CMIO, he serves in enterprise-wide leadership roles within Johns Hopkins' technology innovation center and data trust initiative as well as the deployment of the health system's unified Epic EHR.  

Dr. Greene was appointed CMIO at Johns Hopkins in 2006, and he also serves as the health system's associate dean for emerging technologies. He is a graduate of Cambridge, Mass.-based Harvard University and Yale University School of Medicine in New Haven, Conn.

Here, Dr. Greene discusses the biggest challenge he faces as CMIO as well as the issue surrounding efficiency of EHRs.

Responses have been lightly edited for clarity and length.

Question: What do you find frustrates your clinicians most about the EHR? 

Dr. Peter Schuyler Greene: Efficiency is really at the heart of what troubles us most. Clinicians really want the EHR to make their work easier. Current EHRs takes up too much of their time and pull them away from face-to-face time with patients and care teams. This impacts work-life balance. Another frustration is that EHR notes are efficient to create but often hard to read because of macros and copying functions and practices. We really need to revisit the gap between notes that people create using tools that the EHR has versus what they would really like to read.

Q: What technology has Johns Hopkins Medicine implemented to improve data sharing between patients and clinicians? 

PG: We opened up notes in our patient portal a few years ago, which has been very popular because it lets the patient understand better exactly what the physician is writing about them. More recently, we rolled out an Epic Bedside patient portal for hospitalized patients and that give the patient a better view into what's going on in the hospital. We have also implemented interfaces with Apple Health and Google Fit. We are really excited about giving patients control over their health information.

Q: What type of patient engagement have you seen with smartphone integration? Are patients receptive to it and what pace are they adopting it?

PG: It's slow, and it's early. I'm not sure that I expected it to be much faster because the initial capabilities are very similar to what patients could already do with the mobile smartphone apps for EHRs, like Epic MyChart in our case. I do think that trajectory of the industry is really exciting here because app developers will have a much larger set of capabilities with the patient's EHR data, and there are a lot opportunities to get the patient more engaged. This is critical for improving both the quality and affordability of healthcare.  

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

PG: I lie awake at night worrying about how to bring intelligent systems into EHRs and clinical workflows. We know that there are many opportunities to leverage machine learning and artificial intelligence, but where and when are we ready? Which machine learning models have truly actionable insights? And what is worth making an investment in now? Sometimes we can leverage a simple machine learning tool within our EHR, but in other cases we need a more sophisticated outside system. I feel like we have an amazing opportunity to reinvent healthcare processes but navigating fitness for purpose and our own readiness is a big challenge.

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