Rich started out by offering a brief introduction to himself and to Deborah Heart and Lung Center, a cardiovascular specialty hospital with adjacent services that roll into impacting on the heart and lungs, and an alliance member of the Cleveland Clinic Heart, Vascular, and Thoracic Institute, which has the benefits of “sharing best practices with one of the biggest names in the country”.
Rich shared: “We are one of three hospital systems in the country that, as part of our mission, do not send bills to patients. We bill insurance and whatever we get from insurance, we take that; we take care of everyone we can possibly take care of, and our founder’s motto is that ‘there should be no price tag on life.’”
On his experience in digital and health, Rich said, “I’ve been doing this for more years than I can count – I’ve been a consultant on the vendor side, I’ve been a chief information officer at other places, so I’ve been around the block. But it’s been great to do this in a new and progressive setting.”
Digital projects at Deborah Heart and Lung Center
Rich shared some of the projects he’s been working on at Deborah Heart and Lung over the last 12 months, including “making the organisation up-to-date with analytics and up-to-date dashboards, being able to visually see data in a way that informs critical decision-making”.
He explained: “We have a tool from within our MEDITECH EHR for business and clinical analytics, and we’ve rolled that out in a number of different ways to make sure we have the data and information we need to optimise our patient experience, and to make sure that our quality indicators are what they need to be. We also use analytics extensively for census tracking, which is not a novelty; but I think we do it in a more robust and visually appealing way. We also use analytics for tracking bed requests and how long that process takes, and in all of our procedural areas. We do things like tracking first-starts, making sure that if a patient is supposed to be in the operating room at seven in the morning, they’re in at seven in the morning.”
Analytics and dashboards are also used for things like time studies, to find out how long it takes from a patient walking in, to the time they’re seen at the front desk, the time they’re in the exam room, and how long it takes to complete the encounter and have them “on their merry way”. Much of this type of work, Rich continued, is around looking for patterns, working on process improvement based on that, and using quality indicators to track “a million different things” across the hospital.
The patient experience is at the centre, Rich continued. For Deborah Heart and Lung, this can be “a real differentiator” from other big systems in the area, especially “if we can compete effectively with them by providing a personalised and easy-to-access patient experience”.
A lot of time is spent on patient portals, he said, noting that “we’ve made a lot of progress in helping patients to access the portal for the first time; in adding functionality for patients to secure message providers; and in improving the pre-registration process, capturing information through a questionnaire that patients can fill in online, so it cuts down on them having to provide that twice.”
Also on patient communication, Rich talked about how the organisation has “made a big push” to communicate with patients via text, based on feedback that this is a preferred method for patients, which also means that patients are not kept waiting on hold for an extended period of time. Texts are currently used for reminders as well as informational campaigns, which he described as “a big hit”.
Rich highlighted a focus on interoperability at Deborah Heart and Lung over the last 12 months. He said that health information exchange in New Jersey “is really looking to spread its wings”, with the organisation “at the forefront of that, tapping into that to not only get clinical continuity of care documents into our EHR from other places. But it’s also about being able to get that support, to get notifications, so if a patient is at another location their primary care physician can find out about that.”
Sharing the impact that this work will have for the organisation, Rich said: “It really will allow any provider, or any person who is involved in the patient’s care, to have a 360 degree view of everything they need to know about the patient; not just what’s happening within the walls of the Deborah Heart and Lung Center.”
Focusing on the patient experience
Talking about the organisation’s work on improving the patient experience, Rich said that the organisation has identified the patient portal as “a strategic imperative”, adding: “For many years people have talked about how consumerism in healthcare is just around the corner, but now it’s here. People will make decisions on where they get their care in large part based on what their experience is with interacting with that provider – getting an appointment, getting information, being able to access resources, and so on. We provide an experience where they can do a lot of the heavy lifting from home.”
On the organisation’s EHR, Rich told us that “as a smaller hospital, MEDITECH is a good fit for us. We’ve been with them for 25 years, and we’re trying to optimise workflow processes; to make it easier for providers, nurses, and any affiliated healthcare staff to be able to get from point A to point B from their charting and documentation experience, with as few clicks as possible.”
He continued: “We’re also looking to deliver more informational content to providers at the point of care – being able to have access to outside medical record information to inform decisions, being able to improve the prescription process so that we can see what those meds are going to cost at the point of care, and bringing as much information as we can in. We’re looking at how we may be able to integrate artificial intelligence tools into MEDITECH to automate some processes, like listening to dialogue in a patient encounter and creating a clinical note from it.”
Priorities for the next 12 months and beyond
On looking ahead to the next 12 months and beyond, Rich shared a few of the organisation’s priorities for digital and data, and some details on upcoming projects.
“We’re in the process of going through a strategic plan, and I think certainly making MEDITECH an even more robust tool for us is part of that. We’ll also be looking at improving our mobile capabilities, being able to use as many mobile tools as we possibly can, in a way that is secure and makes sense from a workflow perspective.”
Cybersecurity is another concept that is key for the organisation’s digital future, Rich said, and “making sure that we’re staying as cutting edge as we possibly can in that is a priority”, along with work around data integration.
“Ultimately down the road we want to look at tools that we can use to provide even better care to patients within the MEDITECH platform.”
To close the interview, we asked Rich: what is the biggest opportunity for the use of tech in healthcare?
Rich said: “AI is real. Sometimes we get fixated on flavours of the month, or get all excited about something and then it kind of fizzles. But I don’t think AI is going to fizzle. It’s about doing it in a way that is equitable, that inspires confidence in the output, without threatening people’s jobs. Because I don’t think it will ever fully replace that human interaction, but it can assist clinicians, helping to identify anomalies that the human eye might not be able to see, and so on. There’s so much potential there, but I think that’s a few years down the road.
“How exactly that is going to look, who knows, but we’re seeing some signs, and how we use it is going to be critical to how we’re able to continue to differentiate ourselves and provide the best possible care that we can for our patients.”
We’d like to thank Rich for his time in sharing his insights with us.
