How MIHS slashed hours off providers' daily EHR time: CMIO Dr. Anthony Dunnigan

Anthony Dunnigan, MD, vice president and chief medical information officer at Phoenix-based Maricopa Integrated Health System, shares how MIHS used voice recognition technology to increase EHR efficiency.

With special expertise in clinical informatics and information systems, Dr. Dunnigan serves as an assistant professor in biomedical informatics at University of Arizona College of Medicine in Phoenix. He is also an adjunct faculty member of the biomedical informatics department at Tempe-based Arizona State University College of Health Solutions.

Here, Dr. Dunnigan discusses how MIHS has customized its EHR, including the addition of Arizona's prescription monitoring program to the system, and offers his advice for other hospitals approaching customization.

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. Anthony Dunnigan: We recently integrated our state's prescription monitoring program database into our Epic EHR, with one-click single sign-on and transmission of the needed patient contextual information. Our interface engineers and builders absolutely nailed the design, to the point where it feels like native EHR functionality. The feedback from our end users has been outstanding. Our clinicians have shared that the ability to view this essential information quickly, placed side-by-side with where orders for opioids are written in the EHR, has resulted in dramatically safer care of these patients.

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

AD: I would certainly be aware of what other systems have done, to avoid "reinventing the wheel." One of the biggest benefits of attending the annual user group sessions is to seek out these systems and shorten the development cycle. In some cases we have found what we needed was not truly customization but use of "foundation" technology implemented in a unique way to better meet the strategic needs of users in certain situations.

Also, have an eye toward the future, particularly as the vendors move toward more continual software updates versus annual or biannual large updates, as it may be more difficult to ensure local customizations are not overwritten.

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

AD: Where I have had the most success is ensuring the analysts who are experts in their particular areas of focus, with knowledge of near-future and future technologies, have an active relationship with operational and business owners who are exploring new ways of delivering safe, efficient and high-quality care that drives an optimal patient experience. When we can match those efforts with the right technologies, the results have been truly groundbreaking.

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

AD: We just completed a two-year implementation of an enterprise-wide voice recognition technology suite. The results have been incredible, with some providers stating they have shaved three hours of EHR time out of their day. We were able to leverage our significant IT upgrades in making the experience very ubiquitous for our providers, to the extent where they can now use these tools anywhere in the world where they have internet bandwidth. It really highlighted the amazing teamwork we have across the IT space and our ability to understand how providers practice, to leverage the technology to the greatest extent possible.

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