Surprising change

Earlier today I was sure that our coverage of the 2014 AMDIS Fall Symposium were the most impactful health IT headlines of the week. Then came the news late this afternoon that Karen DeSalvo, MD, MPH, MSc, has left her post as head of the Office of the National Coordinator of Health IT to help manage the Ebola crisis.

I'm sure her background in public health made it difficult for both her and the Dept. of Health and Human Services not to put her expertise to work managing the ongoing situation with the deadly disease.

Meanwhile, the AMDIS Fall Symposium focused on health IT innovation, particularly as it relates to patient engagement and changing behaviors.

Healthcare isn't known for an innovative culture but organizations that fail to act may get left behind, lose stakeholder investment and compromise patient care and safety, said Narath Carlile, MD, MPH, CMIO at ACT.md.

In fact, healthcare organizations should establish a baseline failure rate and assume not all innovative projects will work as intended. If “courageous” companies begin sharing their percentage of failures, someday a baseline failure rate could be established for industry guidance, he said.

Delivering the keynote address, Lyle Berkowitz, MD, associate chief medical officer of innovation at Northwestern Memorial Hospital in Chicago, said the correct and efficient use of technology would allow doctors time to take care of everyone and avert any risk of a physician shortage.

Berkowitz said in the future doctors will see fewer patients but take care of more patients as part of a larger care team—in a “really high value, high quality way.”

Innovation can help U.S. healthcare get to that point, he said. Innovation involves three “Es”: explore, experiment and expand. Innovators should observe and investigate to understand what’s out there, then try out pilots or prototypes. Start wide and narrow down the focus, he said, to decide what to try and why.

Berkowitz said we could have much more usable EMRs today had developers focused on human-centered design thinking, or creating around the end user. “That seems self-evident but it often is not the case.” He said you can optimize a product around how users want or need to use the product rather than forcing users to change their behavior to accommodate the product.

Healthcare organizations can borrow from others but have to make it their own, Berkowitz said. “Take away the essence and make it work for your organization.”

Berkowitz also advised that “it’s okay to start small—little bets can equal big wins.” At his own organization, he created a small program that involved lending iPads to patients. It took him more than six months to get the program approved and people said the devices would get broken or stolen. He countered by saying they wouldn’t know that until they tried it. It also let the organization get some experience before implementing a bigger program.

These and other sessions during the two-day meeting certainly offered much food for thought. If you were not able to attend the conference, I hope you read our coverage online.

Beth Walsh

Clinical Innovation + Technology editor