The downsides of implementing new technology: Q&A with MSU Health Care's CMIO Dr. Nathan Fitton

East Lansing, Mich.-based MSU Health Care's new chief medical information officer Nathan Fitton, DO, is looking to augment his organization's electronic medical record system so that it can provide staff and providers with enhanced clinical interactions. 

Becker's spoke to Dr. Fitton about his new role, the downsides of implementing new technology and how MSU Health Care is using technology to control costs. 

Question: How did your role as an associate chief medical information officer for MSU Health Care prepare you to take on the role of chief medical information officer?

Dr. Nathan Fitton: I was very grateful for my time as an associate CMIO and viewed it much like residency, just without the pager. This period of apprenticeship was paramount to my development. As they say, it takes a village, and I was no exception. Our CMIO at the time, Andrew Zwyghuizen, was instrumental. His leadership and experience afforded me ample opportunities to learn. 

Additionally, the entire IT team was an incredible resource. Their patience to teach the various aspects of their critical roles allowed me to better understand how so many integrations fed into our EMR and are viewed as a single product. I had a newfound appreciation for the work that went on behind the scenes. 

Q: How is MSU Health Care utilizing tech as a way to control costs and improve patient care? 

NF: As an organization's leader for medical informatics, there is no time for complacency. The amount of data that is being utilized to enhance patient care is being expanded upon daily. While this is exciting, it is tremendously challenging. There are improvements in data collection and reconciliation that occur hourly, and without constant maneuvering you can be stuck in the past.  

We utilize dashboards to help improve patient access to our world-class providers. This gives us real-time information on patient wait times, cancellations and referrals. We have used this to understand our bottlenecks and reduce the time it takes for a patient to see our clinicians. We have also been using robot process automation for repetitive tasks that free up staff for other responsibilities and reduce the burden of tedious processes. 

One of our newest initiatives is remote patient monitoring that allows for tracking of health risk factors from home. This allows for early intervention and prevents severe exacerbations, keeping our patients healthier and out of the emergency department. We have expedited our pre-arrival check in process through a program that allows for a patient to complete all necessary documentation for check-in prior to their appointment. Allowing them to simply arrive, check in and immediately be ready to be seen. This has improved clinic flow and efficiency, reducing patient down time. 

Q: Part of your role is to be in charge of the implementation and operations of MSU Health Care's electronic medical records. How do you continue to make sure you're optimizing your EMR system to meet clinicians' needs?

NF: The electronic health medical record is an imperative part of the day-to-day operations but it is so much more than charting. We are fortunate to deliver incredible care from numerous specialties, affording our community the ability to see the widest array of specialists. With this, though, comes the tremendous task of meeting the needs of those clinics.

Each specialty is unique and has its own needs. My goal is to support them and provide them with an EMR that not only meets but exceeds their expectations. My goal is to provide all staff with an EMR that augments and enhances their clinical interactions and is not an impedance. Admittedly this is an overwhelming task and one I am constantly striving for but the goal nonetheless. We collaborate with our EMR to find efficiencies in all aspects of its function. We serve as both an alpha and beta site for testing. This allows us to access the most up-to-date enhancements as well as contribute direct consumer feedback.  

Q: Generative AI such as ChatGPT is being touted as something that can change healthcare delivery. What do you think are some of the promises and pitfalls of this technology?

NF: This tremendous technology certainly has the possibility to revolutionize not only healthcare but the world. Technology like this, though, must be carefully and judiciously reviewed. While powerful, it was not solely designed to deliver medical care. With that being said, I am very excited to see its growth. 

I think the potential is in its ability to augment clinical decision-making; the pitfall comes with over-reliance. The complexity of medical conditions and overlap of symptoms require keen clinical decision-making that I feel will challenge this technology initially. Regardless, its ability to produce up-to-date information and recommendations should rapidly enhance clinical practice.

Q: How do you manage the potential downsides of implementing new technology?

NF: This is a very difficult issue for our team. Many advancements can be promising, but delivery and real-world use is another story. Additionally, technology advances so quickly we must remain cognizant of when to implement upgrades. Taking too much time to thoroughly understand and vet a product can lead to falling behind, whereas rushing a product can result in failed expectations. 

One of the most difficult tasks for our team is change management. If we pushed out updates and changes weekly we would overwhelm our staff, but waiting too long creates confusion. Furthermore, pushing out inadequate products reduces confidence. Given all of this, we still must be ready to meet the needs of our organization. This has led to an efficient and nimble department with immediate oversight to be able to quickly address the needs of our organization. 

Q: CMIOs have to serve as a bridge between the medical departments and the IT department. How do you balance advocating for both sides?

NF: This is one of the most challenging aspects of my job. We have staff that bring forward legitimate recommendations, but decisions aren't made in isolation. The impact across our organization must be considered. 

As a result, compromise is ever occurring. Creating and fostering an environment of collaboration is imperative. Bringing together groups of such different backgrounds can be challenging, but the creativity and problem-solving is incredible to be a part of. I enjoy this because all vested parties have the goal of enhancing patient care and the way we deliver it.

Q: Any new exciting things happening at MSU Health Care in the technology sphere? New partnerships or initiatives you'd like to share?

NF: I couldn't be prouder to be associated with MSU Health Care. One of the more cutting-edge offerings we have at MSU Health Care is utilization of virtual reality to augment care. Jamie Clarkson, MD, is a hand surgeon that has been able to transition many of his procedures to be performed in office and to improve the patient experience; he is using virtual reality. 

He is currently enrolled in multiple studies about this and has already found virtual reality reduces anxiety and pain. This has been a tremendous asset to our patients and one that is well received, so much so that other providers are beginning to use this first-of-its-kind offering. We are fortunate to have providers like Dr. Clarkson who are advancing patient care through technology. 

One exciting partnership we are actively engaged in is with the Patient Access Collaborative. We have been involved with this organization for years and have been benefiting from the collective partnership. 

This organization works to break down barriers to patient access. One out of every 5 outpatient encounters in the U.S. is provided through one of its members. This creates a tremendous network to work with and learn from.

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