At next week’s Association of Medical Directors of Information Systems Physician-Computer Connection Symposium in Ojai, Calif., a substantial amount of time—two sessions in fact—will be spent look at clinical decision support.
One of the presenters will be Scott Weingarten, MD, MPH, senior vice president and chief clinical transformation officer at Cedars-Sinai Health System in Los Angeles. He was the co-founder, president and CEO of Zynx Health, a major player in the clinical-decision support system market, and he has spoken numerous times about clinical decision support and related topics in the U.S. and internationally.
Why this emphasis on clinical decision support at AMDIS PCC 2014? “I can’t speak for all of the conference organizers, but my take is that many organizations have spent a lot of money buying EMRs,” Weingarten said “And in many cases, it was challenging to implement them. And now people are starting to ask about the benefit. Has it helped patient care and has it helped the bottom line, and is it helping organizations prepare for risk-based managed population health?
“And I think the way that EMRs improve patient care and achieve a return on investment will be through clinical decision support.”
According to Weingarten, there are two things going on affecting clinical decision support that he will be pointing out in his presentation. The first is that substantial investment organizations have made in their EMRS and the fact that organizations “are starting to amortize those investments.”
At the same time organizations are dealing with healthcare reform. “So you have organizations that are preparing for accepting risk-based payments, that are trying to manage risk and prepare themselves for the future, and the question becomes, ‘how will you be able to use the EMR, from a clinical and quality perspective—as well as a financial standpoint—to prepare for the future of health care.”
With that in mind, Weingarten will be talking about the experience at Cedars Sinai where the organization embedded Choosing Wisely recommendations from dozens of medical specialties into its EMR in little more than two months, dramatically increasing the Cedars-Sinai’s pace of adding new alerts from one or two a month, to well over 100 in two months.
Weingarten points out that organizations need to remember that an EMR implementation is only the beginning of a long process. “You go live and you celebrate, but then the hard work begins,” he said.
As far as a CMIO is concerned, a key question to ask is what are the key strategic priorities of his or her organization.. These probably include measurable improvements in quality of care, outcomes of care, and costs of care, Weingarten said. He added that the CMIO will play a critical role in taking this investment in an EMR and making sure it delivers the benefits that are in line with the strategic priorities of the health system.
Of course, CMIOs are “very smart people and already know all this,” Weingarten said. “But, on the other hand, there are few organizations that I am aware of that have yet been able to demonstrate a significant clinical and financial benefit commensurate with the purchase price [of an EMR]. That will change, and the reasons that will change is that CMIOs will be thinking very carefully about the benefits of clinical decision support which will enable them to demonstrate clinical quality and financial benefits to their CEOs, CFOs and boards of directors.”