Takeaways from AMDIS: What CMIOs are Talking About
By Wendy Kerschner
After a COVID-19-induced hiatus, WittKieffer was happy to return to the Association of Medical Directors of Information Systems (AMDIS) 31st Annual Physician-Computer Connection Symposium in Ojai, California. My colleague Hillary Ross and I were fortunate to attend, along with more than 150 medical informatics executives.
The pandemic was undoubtedly responsible for increasing the use of and reliance upon information technology as a core part of patient care. This subsequently led to an elevated and expanded role for informatics leaders in many organizations. Chief medical informatics officers (CMIOs) and other informatics leaders seem more energized about their abilities to make an impact.
The Symposium provided an excellent opportunity for knowledge sharing, problem-solving and planning for the future as complexities of demands increase and new opportunities arise. It was inspiring to be immersed with so many informatics leaders representing a diverse group of organizations from across the nation.
The following were items that were top of mind during presentations and informal break discussions:
New Models of Care Delivery:
Technology is expanding the options for care delivery platforms that providers and patients use. A representative from the AMA shared findings from a recent survey of their members regarding telehealth usage. The results demonstrate the positive impact telehealth has on the quality of care, patient experience, and professional satisfaction. The survey also highlighted the need for improvement in ensuring equitable access, developing telehealth-specific workflows and better integrations with EHR systems.
Patient portals and emails are also exponentially expanding as a widely used platform to deliver care to patients. Dr. Colin Banas of DrFirst and Dr. Bill Galanter of UI Health noted that patient messages are up 157% from pre-pandemic levels. With these new platforms comes the question of how and to what extent providers are compensated for care. Dr. Russ Cucina, CHIO at UCSF, presented on how his organization is addressing the nearly 100% increase in MyChart messages the health system has faced since 2019 and the approach they put in place to bill for the care given through MyChart. A representative from CMS also shared updates related to fee schedules in covering telehealth and virtual services. It is likely this trend and high usage rate will continue and CMIOs will need to continue to optimize current platforms and identify new workflows and integrations within the EHR.
Exploding inboxes, alert fatigue and poorly designed workflows are just a sample of the burdens clinicians and other healthcare workers face on a daily basis. Dr. David Chestek, of UI Health, addressed the “perfect storm” of factors that are leading to increased burnout and how the pandemic has exacerbated all of these problems. Dr. Colin Banas and Dr. Cliff Galanter shared a recently published study about the Clickbusters initiative led by the Vanderbilt Clinical Informatics Institute, identifying practices to improve safety and quality and reducing burnout in Epic. Informatics leaders are identifying ways to combat these challenges and identify strategies for technology to make employees’ lives easier rather than harder.
Diversity, Equity and Inclusion:
As healthcare organizations continue to address challenging social and cultural issues, the informatics community is proactively finding ways to increase the profession’s diversity. In an interactive session many participants shared their personal experiences about overt discrimination and microagressions they have encountered throughout their careers. As Dr. Margaret Lozovatsky of Novant stated, “It is not enough to have a seat at the table, we need a voice at the table.” Panelists discussed how diversity and inclusiveness in healthcare leaderships leads to better employee loyalty, innovation, performance, customer insight and sense of belonging. Creating a more inclusive environment is critical in ensuring different ideas and perspectives are shared, which will lead to better solutions to combat inequity in healthcare.
AI continues to be a topic of interest as leaders determine how best to leverage its cutting edge capabilities to improve patient outcomes. We are still at the early stages. Dr. Anthony Chang of Children’s Health Orange County and founder of Artificial Intelligence in Medicine, who led the discussion, expressed that he felt we were just in the “medieval era” of harnessing the power of this technology but organizations are already seeing benefits in leveraging deep learning, big data, natural language processing and other tools. In another session, Dr. Robert Budman of Nuance Communications spoke about how AI can be used to address issues related to burnout including eliminating the keyboard during patient interactions and maximizing automation to reduce administrative time. Attendees were energized and engaged to think through how machines and humans continue to work synchronously to improve all aspects of care.
The presentations and discussions at the AMDIS annual gathering reinforced the incredible importance CMIOs play in addressing healthcare’s challenges and identifying solutions to dramatically move the needle to improve clinical outcomes, drive research and innovation and increase provider wellness and efficiency.