Showing Rx Co-Pay Cost at time of Prescribing, in the EHR (info transparency!)

Sometimes you work hard, and cool things happen. UCHealth is partnering with RxRevu, makers of SwiftRx, an EHR-embedded tool that shows prescribing doctors the co-pay cost of patient medications AT THE TIME OF PRESCRIBING! We believe we’re one of the first in the country to do this successfully.

Yes, at the time of prescribing. NOT the usual “guess-again” game that we’re all tired of. “Hey, I’m gonna prescribe doxycycline from this chronic condition. It’s an older drug so, I’m GUESSING it will be inexpensive at the pharmacy, but WHO KNOWS?!” And then the inevitable phone call “Doc? That prescription has a $241 copay! Isn’t there something else?”

We are all tired of this game.

After quite a bit of hard work and innovative partnering with RxRevu, we are pleased to have launched, about a month ago, the ability for our docs to prescribe medicines within our EHR, and (like magic!) right within their workflow (don’t have to make a phone call, don’t have to launch a web browser and figure out the patient’s insurance specifics, or look up in some massive formulary book), right in our EHR, we see the co-pay! The Real-time benefits check shows up in about 1-2 seconds, just like above.

With that particular patient, we saved him about $200 by switching from tablets to capsules. Silly, but true.

Here’s the news article on SwiftRx at UCHealth.

Here’s the recent webinar I participated in describing this innovation.

CMIO’s take? There are so many ways information transparency will help us and our patients, in healthcare. Have you found success with information transparency? Let me know!

EHR Sprint Optimization Executive Summary – using Stories, Images AND Data to change minds

Many of you know that in my role as CMIO at UCHealth, I’ve stepped in my share of potholes. My Failure Resume is replete with examples (eg: my 16 year journey to implementing Open Notes). Having studied the Open Notes phenomenon back in 2000 and published in 2003, it was a big disappointment when, after presenting to the medical leaders at University of Colorado, I was soundly voted down for implementing this transparency initiative (sharing doctors progress notes with patients online) repeatedly in 2002, 2003, 2004, until I stopped asking. Then, about a decade later, AFTER the Open Notes organization (thanks, Tom Delbanco and others) formed and pushed the agenda in 2011, we gathered steam and I finally succeeded in May 2016 to implement Open Notes system-wide for several million patients). You can call it a failure or an eventual success.

Nevertheless, when we implemented our Sprint Team for EHR optimization, we were at risk of being disbanded and told to return to our usual jobs (I had “stolen” these resources from IT and informatics to “Sprint” one endocrinology clinic of 29 doctors). In defense of our program I wrote this 1 page Executive Summary. We know that readership of white papers drops by half with every additional page. I included images/graphs (internal marketing, make your document attractive and interesting), STORIES (because, what p-value has ever REALLY changed someone’s mind?) and DATA (because, what self-respecting doctor or leader DOESN’T ask for evidence?).

And no, it wasn’t an overnight success, but it was one of the core documents that drove our executive team to finally approve the budget to continue our Sprint efforts. Download the 2-year-summary version below.

https://www.dropbox.com/s/o3qh33l7wdna3xe/2018-08%202y%20Sprint%20Aggregate%20Exec%20Sum.pdf?dl=0

We have now sprinted over 750 clinicians, hundreds of ancillary staff (MA’s, RN’s, front desk clerks), over 70 clinics, with uniformly RAVE reviews. And, even better news, we were recently funded to DOUBLE our Sprint team to 22 people. We are grateful to our leaders for such foresight.

CMIO’s take? Sometimes internal marketing can be as or more important that external marketing. Do you have success stories of how you wrote/composed documents for success? Let me know.

Time management regret? (NYTimes) Work-life (im)balance? Start now.


We can all benefit from reminders. And self-forgiveness. And taking a single step, (or creating the “next action”) as David Allen says in his book “Getting things Done (book summarizing video).” Atomic Habits (book summarizing video) is another book with similar suggestions. There are a growing number of books, articles, videos dedicated to this topic; go ahead and explore. After all, the ancient Chinese saying is: “The journey of 1000 miles begins with a single step.”

We are all burdened with too much work and too little time. If we are not careful, our work overwhelms other parts of our lives and we lose balance. I struggle with this myself. It is helpful, then, to have a quiver of tools to deploy in the moments when your self-awareness kicks in: “whoa, I’m out of balance; I missed my kid’s field hockey game, or that school event, or the dinner with my family.” Or maybe all of the above. 😦

In these moments, as the article suggests, break it down to ONE action.

  • Forgive yourself. Move past it and commit to behaving differently NOW.
    Self-disappointment gets in the way of personal progress.
  • Do ONE thing. Leave today, early enough to go exercise, for example.
  • Find a SMALL thing to change. “Managing time” is a huge monster, but getting THIS particular project started involves finding THAT one phone number. There. That’s progress.
  • Read a book about process (This works for me, instead of doing better, read about doing better, maybe implement ONE idea from it, and rejoice. As you read more and pause and reflect more often, you WILL find more opportunities to change or establish a new habit. It is okay if this takes weeks, months, years, decades. We are all works-in-progress.)
  • Set yourself a task for teaching Work-Life balance. Nothing like see one, do one, teach one, like we did in medical school. Or worse yet, don’t even see one or do one, but figure out how to TEACH one, and that forces you to examine yourself and pay attention. (Speaking of which, come to the CMIO Leadership Academy where I’m going to be teaching … Work Life Balance). Hilarious!

CMIO’s take? Having trouble managing time or really getting started changing yourself? Break it down into a small “next” action. Read the article. Watch a YouTube video. I’m surprised at home many authors now offer their best ideas on video or in short articles. Are Books “so last century”? Maybe so.

Why we still love tech… (WIRED)

Detail of a Monet. Captures the wistfulness of this post…

https://www.wired.com/story/why-we-love-tech-defense-difficult-industry

Paul Ford is CEO at PostLight and recently wrote an impassioned “Proudshamed” reflection on his career growing up with tech. I resonated with a lot of it, as CMIO with responsibility to improve the digital lives of our patients and our physicians.