The Exec: Mental Health Looms Large Post-COVID

By Christopher Cheney

Addressing mental health needs is a primary aspect of healthcare in the post-COVID world, the new chief medical officer of MSU Health Care says.

Michael Weiner, DO, MSM, was named the new CMO of MSU Health Care, in East Lansing, Michigan, last month. Prior to joining MSU Health Care, he served as CMO for Maximus, a public company that contracts with government agencies to make them more accessible and affordable. He was previously chief medical information officer at IBM, where he led the healthcare solution teams in infrastructure, analytics, consumer engagement, and cognitive computing. Previously, as both CMO and CMIO for the U.S. Department of Defense, his office was responsible for a significant enhancement to the Veterans Affairs electronic medical record.

HealthLeaders recently spoke with Weiner about a range of topics, including clinical challenges now that the crisis phase of the coronavirus pandemic has passed, electronic medical records, and physician leadership. The following transcript of that conversation has been edited for clarity and brevity.

Michael Weiner: The tsunami that is coming our way post-COVID revolves around the mental health needs of the populations that we serve. People are going to start reaching out for the mental health support that they have come to realize that they need, whether that be loneliness, depression, or anxiety. These topics have all come to the forefront of care in America today across all age groups.

Post-COVID, we are going to have a focus on mental health. We are fortunate to have an amazing mental health department at MSU Health Care that we look forward to relying on to support this burgeoning population of patients who have increased mental health and behavioral health needs.

HL: What do you anticipate will be your biggest challenges in serving as CMO of MSU Health Care?

Weiner: The challenges for the CMO at Michigan State University are the same challenges that are affecting medicine in 2023 across the nation. There are increasing patient needs, decreasing provider resources, technology is being added to the mix, there is more and more provider burnout, and we are all living in a post-COVID world.

On the patient side, we are seeing an increased need for mental health services and an aging population. We are seeing shrinking resources to support those populations and are layering more technology into the provider workflows that is increasing burnout even further.

HL: How can a CMO rise to these challenges?

Weiner: We need to address these challenges one-by-one. There is nothing we can do about the changing demographics of aging populations that come with more diabetes, more obesity, more hypertension, and more mental health needs. We just need to understand that these patients are coming, and we need to support them. We may not have control over this challenge, but we do have control over what we can do and offer to the populations that have entrusted their care to us. We can make sure we have the right tools, the right people, and the right teams to support them.

We need to get to the root causes of burnout for our providers and our support staff. Like anything else in the world, burnout is a complex mix of factors. We were already looking at provider burnout pre-COVID, then COVID caused even higher degrees of provider burnout, and we lost providers throughout the pandemic. So, our goal is to build the pool of providers back up. We are actively recruiting providers to come and join our team. Our goal is to make MSU Health Care the place to work in America.

HL: How will your experience serving as CMIO at IBM help you in your new role at MSU Health Care?

Weiner: Burnout is tied to many of the new technologies that have been given to our providers. If you look at the core of that, there is an electronic health record that was mandated years ago, and many providers are skeptical that EHRs were created with them in mind.

What I was able to learn at IBM is that there are many new technologies emerging in support of better patient care, better quality care, and increasing access to care. If we go back to the concerns about providers, how do we make the electronic health record experience better for our providers and staff? We cannot forget our nurses and medical assistants who are all interacting with the same technology and have had many of the same frustrations. We need to concentrate on technology to make that experience better.

We have learned there are things we can put into the system such as voice recognition technology integrated with our electronic health record to improve the workflow of seeing a patient. Right now, our job is to listen to the providers, hear what they are asking for, and begin to deliver to improve their experience. If we can take good care of our staff, that allows our staff to take amazing care of our patients.

HL: How will your experience enhancing the EHR at Veterans Affairs help you in your new role at MSU Health Care?

Weiner: While working at the Department of Defense and working with the VA, I had the opportunity to serve large populations of providers—thousands of providers. After a while, you begin to realize the challenges for providers are common regardless of where they are practicing care. Whether a provider is working at the VA or an academic medical center, the challenges are largely the same.

I have been able to take lessons learned at the VA and bring them to this incredible academic medical center. With this experience, I am hoping to achieve progress more quickly.

The one thing we worked on at the VA and are hoping to bring here is optimization, which becomes a life-long journey in whatever electronic health record you are using. The electronic health records are typically developed with teams of experts and users of the system—we call them “super users” who are high-end users. We want to be able to take the lessons that the electronic health record vendors have built into their systems and bring those across to our own providers, so they can be more efficient, optimize the way the system is used, be able to document more quickly, spend more time with patients, and get home at a reasonable time.

HL: Is there anything specific that can be done to electronic health records to make them more user friendly for clinicians?

Weiner: You must aim for optimization of the electronic health record. For example, when I see a patient, if I have to click 40 times to get from the beginning of the patient encounter to the end of the patient encounter, is there a more optimal way to do that? Is there a way to get through in 20 clicks? Is there a way for me to be able to dictate into the blocks I need to fill out to make it more efficient for me?

One solution is advanced optimization training, which is having elbow-to-elbow experts working with the physicians as they see patients to improve their workflow within the electronic health record. There are also technologies that can make the experience better for clinicians and patients. We have adopted patient-supportive technology to make it easier to sign in, to make it easier to give medical history, and to avoid filling out pages of forms when you see a doctor. You can also bring in additional support such as scribes to help do the input work. We are looking at optimizing the electronic health record to improve retention and to make us a more attractive employer.

HL: You have a clinical background in internal medicine. How will this clinical background help you serve as CMO of MSU Health Care?

Weiner: I believe that primary care is the basis of care for a population. I am a primary care physician, and being able to support patients holistically in their journey through the healthcare system is invaluable in helping to elevate the health of an entire population.

Serving as a primary care physician helps me serve as CMO. It gives me an understanding of the care of a population and an understanding of my primary care colleagues who provide care to patients who seek care at Michigan State University. It also has involved years of interacting with specialty care providers who also support our patients. So, I know the primary care side and have worked with specialty care providers for two decades, and this will help me bring us together as a tightly knit team.

HL: What are the primary keys to success in physician leadership?

Weiner: At the nd of the day, providers have three requests of their leadership.

Number one, they want to be listened to. They want someone to hear them. Providers do incredible work taking care of complex populations, and they have asks. Since I began working here, no one has asked for anything unreasonable given our collective goal of delivering better care.

Number two, they want to be supported. How do we offer them the support that they are asking for?

Number three, they want to work with someone who is also seeing patients. In my role, I am working with patients with a full clinic schedule.

Those three things make for a good physician leader at a health system, particularly a good CMO.

Christopher Cheney is the senior clinical care​ editor at HealthLeaders.