“Takeaway from the CHIME conference? Takeaway from the CHIME conference… What did I see? What’s the most important thing that happened? What’s the lesson?”
As I sat down to write my post-CHIME Fall Forum column (which you are currently reading), I tried the above line of inquiry, one that usually works to get the keyboard clicking. But the more I thought along those lines, the more I realized that, when it came to the last CHIME event, the takeaway was not something I saw, but something I did not see.
I did not see, nor hear, a lot of complaining. I did not see a lot of stressed-out faces, and I did not sense the misery and suffering from being overworked and beaten down — usually by disgruntled clinicians — that I have felt at past industry events. And the more I thought about it, the more I think it may be due to the industry’s general transition from system implementation to system usage.
If we look at the Meaningful Use program from a high level, most organizations have finished the work of putting their systems in. And, as anyone involved with such projects knows, it is in the “putting in” that CIOs can incur the most beating up. It is during the putting in that workflows are dramatically changed (perhaps obliterated and recreated is more accurate), that folks trained and quite comfortable with scratching out some words on paper — seemingly indifferent to whether they can be read — or mumbling an order to a nurse, have been forced to navigate checkboxes in the hopes of creating structured data, in the hopes of seeing an alert that can save a life. It is in the putting in that those same alerts usually begin as an inevitable torrent of irrelevant interruptions which must be braved before the system can be fine-tuned — their cascade slowed to a meandering creek, then a trickle, then stopped.
So, in short, it has been a very rough couple of years for a very many CIOs, but just maybe, the worm has turned, and the time for absorbing abuse is over.
Perhaps this is because the hard work of erecting the house is finished, and now we get to check out the rooms, do some decorating and start enjoying the yard. Perhaps it has become the time when, rather than forcing change upon clinicians, CIOs are getting (though pilot projects at first) to deliver up useful and actionable information to those folks at the point of care — information that helps them make people better, faster, that helps them save lives. And here is an important point — that is what they really want to do.
It is at this point that things get fun, that the CIO can go from hindrance to helper, that rather than being on the fringes of patient care, technology becomes the number one enabler of it; that, in a sense, you stand side by side with the doctor, rather than giving him irritating shoves from behind.
I heard about one such enabler, one such project, during a track session at the show: “An Acuity Scoring System to Drive Efficient Care and Quality Patient Outcomes,” with Shafiq Rab, MD, MPH, VP of IT and CIO; Jeremy Marut, Director, Enterprise Architecture; and Eric Durfee, Clinical Systems Analyst — all of Hackensack University Medical Center.
In it, they described a program by which the data collected through their electronic systems is being turned into useful information at the point of care. Rab revealed a significant reduction in mortality, along with ICU admissions, which resulted from their work.
As anyone who knows Dr. Rab might expect, the session was “unstructured” — which, of course, made it lively, fun and interactive. And perhaps his best quote came off the cuff, but obviously from the heart. When asked what the program’s cost, he shot back:
“I don’t give a damn what it costs. I’m a disruptive CIO. I’m here to save lives.”
Now, first off, I know he does give a damn what it costs, because that is part of being a good CIO, but I also understand his point.
And I think that is why many CIOs at the CHIME Fall Forum were upbeat like Rab, energized and ready for the next few years. Because much of the most unpleasant work is done, and now, finally, it’s time to save some lives.
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