Thanks to my collaborators on the Patient Radiology Image Viewing team at UCHealth: Evan Norris MD, Ciarra Halaska, Justin Honce MD, Peter Sachs MD, and Kate Sanfilippo. Come see our talk at Epic XGM 2021 (eXpert Group Meeting) next month! Session Rad 1.4
What’s the TL;DR? Allowing patients to view their radiology images in their patient portal, alongside their radiology reports, is technically feasible, and does NOT cause increased anxiety for patients or increased workload for providers (in fact, ZERO phone calls, and yet our patients view 39,000 images per month!). Eighty percent of patients liked it. Many showed their images to their providers, some saved copies, some posted on social media! Some had technical difficulties, some had trouble understanding the images.
It is a good start, but there is more work to be done!
I had the pleasure of being interviewed by Mile Hi Magazine last week in regards to questions about how patients can cope with Covid-19 at home.
I responded to such questions as:
So many people contract but recover, is this what our body is designed to do?
Can people determine whether they have the virus without a test on symptoms alone?
When contracted, quarantine is the first step. What’s next in terms for two weeks – nutrition, special foods to eat to help the immune system fight?
Any special foods we should be eating now to be in top immune condition should we contract?
Any over-the-counter medicine to take for the fever or diarrhea?
Should people change out bed linen during the two-three weeks period?
Once fever breaks, is this a key sign that its over?
Should people exercise while body is fighting the infection?
Once over, should person we wait a couple days to ensure no symptoms return?
If Covid-19 is a flu strain, will it mutate into another strain as flu does each season for next winter?
Anything else you feel is pertinent to help people feel they can get over it if infected.
I made one particular point at the end of the interview. I shared our family’s strategy for coping with the anxiety and stress during this pandemic:
Exercise every day
Play or make music every day
Limit yourself to 30 minutes of news or social media daily
Three Good Things. At dinner each of us discusses THREE THINGS we are grateful for, today. INSTEAD of our natural tendency to focus on the negative, this exercise helps us reframe our day in a positive light.
CMIO’s take? I challenge all of us to do THREE GOOD THINGS with our loved ones at dinner every night.
We are incredibly honored and humbled to be awarded Most Wired level 10 by CHIME: the College of Healthcare Information Management Executives.
We were one of the three organizations, out of thousands applying, to be awarded level 10, indicating the highest achievement in superior performance and process for information technology used to improve clinical care. This is the first year that CHIME separated out the awardees into levels 7, 8, 9, and 10.
See my last blog post for some of the details of our presentation at CHIME and some of the projects contributing to our success.
It was humbling to stand by the CIOs from Cedar Sinai and Avera Health to receive the honor. Link to article from CHIME below.
What I said in my acceptance comments, and I stand by them:
At UCHealth, Clinical and IT excellence arises from Partnerships: 1. Partnership between the CIO and CMIO and our teams. We make each other better than we could be alone. 2. Partnerships between UCHealth and our vendor partners: we know that there are more smart people who DON’T work for us, than who do. 3. Partnerships between UCHealth and the CHIME community. Healthcare CIO’s are a brilliant lot. We know we stand on the shoulders of giants. Lastly, we want to pay it forward. More than 3 health systems deserve to be level 10. ALL patients deserve to be treated by a health system performing at its best and we want to see MANY MORE health systems on stage next year.
I’m at CHIME19 this week: the College of Health Information Management Executives, Fall Forum. Eight hundred Healthcare CIO’s and a growing number of CMIO’s are members. My CIO, Steve Hess and I are giving a talk called “Is this the End of Secrecy in Healthcare?” where we outline our (sometimes) rocky journey toward ever-increasing transparency for our patients.
We know that an informed patient is much more likely to be an engaged patient, and engaged patients have better health outcomes. So, how do we increase the information available to patients? We have to overcome inertia, fear, and sometimes, epithets.
We were interviewed by Kate Gamble of Health System CIO to preview the contents of our talk, see below.
I’ve been thinking about giving talks backed by powerpoints. Leaving aside the many talks on “Death by Powerpoint”, the lifeblood of the industry is on slides-man-ship in presenting new ideas to our own organization’s leadership, and at national meetings.
And then you see these lovely presentations by TED speakers who are inspiring, tell great stories, but DO NOT have to provide detailed scientific rigor underneath their high-flying narratives.
We, in informatics, have to contend with both parts of this conundrum: how to tell a compelling story well enough to capture imaginations, and more importantly, purse-strings, and yet back it with enough data and science to be compelling to our very picky bean-counters and scientists.
Further complicating this fact is that often, our powerpoints get distributed by email and have to STAND ALONE to convince others, sometimes. Therefore, the whole TED TALK, with IMAGES ONLY and NO DATA become useless in this context; now we have to figure out EITHER how to write an entire white paper (1-4 page brief that can be read quickly) to supplement any slides we give, or to modify these slides so that they CAN stand alone. Ideally, we can write a powerpoint slide deck that includes enough detail to satisfy data-hounds, and yet engaging enough, with a minimum of words, to create a compelling narrative.
CMIO’s take? Only you can judge if I’ve achieved my goals (see link). This is a summarization of more than a decade of my ‘doing it wrong’ and set of guiding principles that I’ve used to continually improve my own talks. I already presume that you know how to build a Powerpoint deck, and that you’ve read other articles on How-To in powerpoint, maybe Garr Reynolds’ Presentation Zen, or Dan Roam’s Show and Tell. There’s lots out there. But this is my take.
It is always a pleasure to stand up and discuss our Informatics work in public forum. We always strive to reduce physician burnout and the EHR burden by improving teamwork and practice efficiency. As a side effect, we discovered the principles behind Agile teamwork, reducing waste, and the ideas underlying High Performance Teams (both running one, and teaching clinics how to become one).
The talk is 50 minutes and the podium is shared with my colleague Katie Morrison MD, Director of the WellDOM program (Wellness in the Department of Medicine at University of Colorado) and my colleague Amber Sieja MD, Senior Medical Director of Informatics at UCHealth. I’m grateful for their brilliance and collaboration.
The TL;DR is:
Sometimes you have to borrow and steal a team to get started
Get the right people on the bus: a physician informaticist, nurse informaticist, project manager all are crucial
EHR efficiency is NOT only about physicians: it is about teamwork
2-week Sprints are a good timeline: short enough to be urgent, long enough to make some real change in the clinic
Eventually you’ll discover Agile, Lean, High Performance Team principles. Live them, and teach them to sustain yourselves
Thanks to all our EHR colleagues; I’m returning from Epic’s UGM (User Group Meeting: check out the twitter-verse at #UGM19) and learned a ton from other customer presentations and from Epic’s future vision as a company. Here is our contribution: a successful integration of RTBC (real time benefits check) of prescription co-pay, prior authorization data, and “payer suggested alternative” meds, right in the prescriber’s workflow, right inside the EHR. Simple, works fast (pharmacy- and patient’s insurance-specific real-time check within about 1 second) for every prescription written. Now, you can tell the patient “This prescription has a $4 co-pay at Target pharmacy”. What a difference.
This was the difference between my patient NOT paying $291 for doxycycline tablets vs $90 for doxycyline capsules. Really?
See my blog post on RxRevu previously. This is working well, and we’ve scaled up to all 3000 prescribers at UCHealth with excellent results.
TO celebrate, we’ve come to discuss our success at UGM … and (of course) to sing a song. Thanks to Terri Couts, VP of Epic Applications at Guthrie Clinic, co-presenting the topic, and for agreeing to sing with me!
We (Dr. Peter Sachs, Vice Chair of Radiology at UCHealth, and I) recently had the pleasure of presenting our recent quality improvement work at Epic’s XGM (eXpert’s Group Meeting) in Verona, WI this week. In brief, we created and turned on the ability for patients to view their own radiology IMAGES online in their patient portal. We had already been sharing radiology REPORTS with our patients for over a decade, and this is an additional step towards information transparency. We think we are among the first to do this.
Despite some minor misgivings on the part of our clinical leaders, we were given the green light to turn this on. Short answer, over 22,000 patients viewed their images in the first month, September 2018 and … no complaints from either doctors or patients! So, we get to keep our jobs!
If you have 2 minutes, here’s the song:
And, if you have another 25 minutes, here’s the talk, and some Q/A after:
CMIO’s take? It is terrific to have a close community of like-minded physician informaticists and technologists pulling to improve healthcare and patient experience, and celebrating each other’s successes. I’m ever grateful to innovative and inspiring colleagues.
I gave a keynote speech late last year at Technology Awareness Day, hosted by the University of Colorado, Anschutz Medical Campus about Big Data, Tech acceleration, and Artificial Intelligence, as applied to healthcare.
I enjoy making my colleagues uncomfortable. How long will doctors have jobs? Will the AI eliminate internal medicine doctors? If Watson can beat humans at Jeopardy, can it beat me at reading medical literature? Can it be dermatologists at diagnosing skin cancer? Can it beat radiologists at interpreting CT scan images?
It is true that the most complex object known to us is the human brain, with its trillions of neurons and extensive interconnections. From this physical matter, something called “general adaptive intelligence” and “consciousness” arises, neither of which we understand or know how to construct or deconstruct. On the other hand, fundamentally though, isn’t a neuron a collection of physical and chemical processes that we DO understand? And then extrapolating upward then, is it not conceivable that we could eventually figure out how to construct a human brain in all its complexity? Hmm.
Reading books like “Life 3.0” and “Superintelligence” gets me thinking about stuff like this. It is both humbling and exciting at the same time.
CMIO’s take? Decide for yourself. I know, it is almost an hour long, and who has an hour anymore, especially if TED speakers can get their point across in 10 minutes? Well, consider my talk a series of 4-5 TED talks. Yeah, that’s it.