The future of care is virtual, Mount Sinai Health System CMIO says

Bruce Darrow, MD, PhD, chief medical information officer at New York City-based Mount Sinai Health System, discusses the biggest technological challenges CMIOs face and why telehealth will continue to gain traction.

Responses have been 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. Bruce Darrow: Initially my focus was on ensuring that the voices of clinicians and patients were represented in the work of our organization's IT efforts. That is still a focus, but I now spend increasing attention on how emerging technologies can be used by the organization for strategic advantage.

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

BD: Advances in technology have made it easy to start your own IT initiative. In many ways, that is a wonderful thing, but an organization is not doing patients any favors if they have multiple secure messaging and telehealth apps spread across disconnected service lines. It adds complexity for patients and clinicians, increases the strain on the system's interoperability channels and multiplies the potential points of failure for both operations and security.

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

BD: I think that virtual care, especially chat-based care with the option to escalate to video or in-person urgent care, will become an increasingly important component of how our patients receive care. I think that individual mobile apps targeted toward patients with specific health conditions will have a more difficult pathway to success, with many more failures than successes. And the most successful organizations will excel at making the complexity of the digital offerings as simple as possible for their patients to use.

Q: How do you feel about the use of voice recognition technology, such as Amazon's Alexa and Google Assistant, in healthcare? Is there a place for its use within the EHR?

BD: Yes, I expect we will see physicians using these assistants with increasing frequency to surface information buried within the electronic chart, to pull up clinical guidelines, to suggest differential diagnosis based on current symptoms and clinical history, and to do the little things like scheduling an appointment with a specialist or recommending a nearby hospital to a traveling patient with a complicated medical history. And as with every other aspect of their lives, patients will use these technologies to get medical information, schedule appointments, track their health and coordinate care.

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