What physicians want from the EHR & how to get there: Q&A with UC San Diego Health CMIO Dr. Brian Clay

Brian Clay, MD, chief medical information officer at UC San Diego Health System, discusses optimizing physician use of the EHR and the biggest challenge he faces as CMIO.

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. Brian Clay: Although there will still be areas of new EHR implementation as organizations open new clinics and hospitals, today's CMIO has evolved to focus less on implementation and more on system optimization and support of efforts in the areas of analytics and population health.

Many physicians are asking the very valid question: 'You've asked me to put all of this data into the EHR, now can you help me get useful information out of it?' This is a very welcome change in focus as there are many opportunities to both streamline workflow and use the wealth of discrete data in our clinical systems to improve patient care.

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

BC: It's challenging to have a 'No. 1' priority as the CMIO in a large academic healthcare organization. Instead, I've identified our 'north star' as the quadruple aim, providing excellent care and experience for a patient population in a manner that is both cost-efficient and mindful of the work life of our providers and staff. We make every effort to prioritize projects that satisfy multiple aspects of the quadruple aim.

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

BC: The largest challenge has always been managing and prioritizing all the potential projects that we could do with the finite resources available while still maintaining some amount of space to work on innovation. That said, what is almost always front of mind for me today is the physician experience with the EHR and focusing on those efforts with the potential to substantially improve it.

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

BC: I am highly supportive of the efforts of EHR vendors to develop more functionality in the mobile versions of their applications. Physicians want quick and efficient ways to accomplish clinical tasks and cutting the current tether to a wired workstation or a laptop on a mobile cart is a great way to do that. I also believe that expanding capability of patients to manage their own care via patient portals will continue to be important.

In terms of passing fads, I think it might be premature to tag precision analytics and machine learning with that label, but we need to see those technologies integrate with a physician's common clinical workflows before we can expect to see them take off.

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