CMO Strategies for Using Clinical Care Technology

‐

By Christopher Cheney

The latest webinar for HealthLeaders’ The Winning Edge series was held yesterday on the topic of bolstering clinical care technology.

Artificial intelligence is the hot topic in clinical care technology, but yesterday’s discussion focused on other technology capabilities in the clinical care space. The webinar topics included remote patient monitoring, wearables, standardizing clinical pathways in the electronic health record, and establishing alerts and prompts in the EHR to avoid waste in clinical care.

The webinar featured a three-member panel of experts: Ruric “Andy” Anderson, MD, MBA, chief medical and quality officer at RWJBarnabas Health; Joey Seliski, MBA, director of technology strategy and digital health at Allegheny Health Network; and Lori Walker, MSN, chief medical information officer at Presbyterian Healthcare Services.

Best practices for remote patient monitoring

It is essential to have an operational staffing model to support remote patient monitoring. Health systems and hospitals need to have internal staff to manage RPM programs and act on RPM data, the panelists said, adding that a strategic partner can supplement internal staff.

Similarly, health systems and hospitals should have a device management strategy that can be managed internally or with a third-party partner, the panelists said.

Regarding RPM devices, they should be patient friendly, and they should be deployed with patient perspectives in mind.

For clinicians, an RPM program should have a defined purpose such as management of chronic illnesses, including congestive heart failure and diabetes, the panelists said. In addition, the data generated by an RPM program should be actionable for clinicians.

Strategies for wearable success

Successful utilization of wearables in the inpatient and outpatient settings mirrors the best practices for RPM programs, according to the panelists. Wearables should be patient-friendly and provider-friendly, and they should generate actionable data for clinicians.

There are many use cases for wearables in the inpatient and outpatient settings, ranging from monitoring heart conditions to monitoring daily habits of patients to encourage them to embrace healthy lifestyles, according to the panelists. In the inpatient setting, wearables are helpful for patient monitoring because they can allow clinicians and nurses to focus on the most critically ill patients.

Ease of use is important with wearables from both the patient perspective and the clinician perspective, according to the panelists. Wearables should generate data that is instructive for patients, and they should produce minimal notifications for clinicians to avoid alert fatigue. The panelists said vendor support can help achieve these goals.

As is the case with RPM programs, staffing models are pivotal in utilization of wearables, and partners can provide clinical staff to augment the staff at health systems and hospitals.

Successful strategies for standardizing clinical pathways in the EHR must be designed with clinicians in mind, according to the panelists.

These clinical pathways must be integrated into clinician workflows, physician leaders should be engaged from the beginning when crafting order sets, and frontline physicians should be engaged in the process to help drive change.

Standardizing clinical pathways in the EHR has a positive impact on outcomes, including reductions in readmissions and mortality, the panelists said.

Efforts to standardize clinical pathways in the EHR should be tested and assessed to avoid alert fatigue for clinicians, and efforts that add “clicks” in the EHR should be selective and thoughtful. As part of these processes, there should be a broad audience for feedback and leaders should be prepared to pivot based on feedback.

Establishing alerts and prompts in the EHR to avoid waste

Clinical and operational rules in the EHR can define next steps for clinicians to avoid waste such as unnecessary laboratory tests, with the necessity of tests set on evidence-based guidelines, according to the panelists.

As is the case with standardizing clinical pathways in the EHR, leaders should be mindful of alert fatigue and have a process in place for establishing new alerts that includes an annual review of alerts.

Alerts should be monitored to know who is getting them and what those staff members are doing with the alerts, the panelists said, adding that health systems and hospitals need to ensure there are not too many alerts while acknowledging that they have a stewardship obligation to control waste.