AMDIS 2014: Bria—'We know where we have to go, we have to insist on going there'

Twitter icon
Facebook icon
LinkedIn icon
e-mail icon
Google icon
 - William F. Bria, MD
William F. Bria, MD

OJAI, CALIF.--While our healthcare delivery system hasn’t evolved as much as has been hoped, the changes experienced in the U.S. over the last decade “will pale [compared] to what is going to happen in the next decade,” said William F. Bria, MD, CMIO at the HCI Group in Jacksonville, Fla., and chair of the Association of Medical Directors of Information Systems (AMDIS), at the opening session of the annual AMDIS Physician-Computer Connection Symposium on June 18.

Healthcare IT, of course, will play a crucial role in this continuing transformation and provide the healthcare community with “an incredible opportunity to not just go back to the old days, but to leap ahead to a strategy of saying what really works,”

Physicians can now easily see, for example, what happens in a particular disease state and what specifically works and what doesn’t. And from that perspective, Bria said, “why wouldn’t we insist on aggregated data showing what in fact has worked effectively for the outcomes that matter?”

While no one would disagree with that fundamental concept, Bria said, it may be “honored in the breach” in the sense that the feeling is that accomplishing this kind of change is difficult and we “don’t have the tools.”

From the perspective of a practitioner, Bria said, “do I fight for more technical tools, or do I need to really get innovative? [Data] must be usable at the point of care, appropriate to what’s going on . . . and it must be packaged in a new, creative way that really does apply at that moment to the discussion, rather than retrospectively some time in the future.”

And while technology doesn’t replace care, Bria pointed out, it provides the opportunity to continuously improve care.

He referred to a commentary on a journal article on SIRS (Systemic Inflammatory Response Syndrome) in which the author wrote: “Future studies should forego the limitations of using simple, memorable criteria, and instead focus on putting the wealth of electronic data available in the ICU to work in those patients at risk for adverse outcomes as early and as accurately as possible by any criteria necessary.”

“We should be past” the idea of having to rely on the simple, memorable criteria mentioned in the commentary, Bria said. “It should be much better than that. It should in fact be on the basis of the latest information in large populations that actually goes to the point of outcome and says what really works and what doesn’t work. Let’s slice and dice it down to the exact demographic and group this patient belongs to because they don’t want general care. They want the best of care.”

We need the data, but we need the data at the point of care, “before it’s too late,” Bria said. The way that happens, he added, is by working in partnership with IT professionals and executives, “as we are trying to do here with AMDIS.”

“From the perspective that sometimes the most complex problems are solved by the most basic solutions, the solutions of America’s ills requires the best from all of us, and I think we all know where to go,” he concluded. “We now need to insist on going there.”