I think you're referring to this: https://www.wired.com/2015/03/how-technology-led-a-hospital-to-give-a-patient-38-times-his-dosage/ It's a fascinating example of the swiss cheese effect, and should be required…
HIStalk Interviews Sonny Hyare, MD, CEO, ReMedi Health Solutions
Sonny Hyare, MD is CEO of ReMedi Health Solutions of Houston, TX.
Tell me about yourself and the company.
I was born and raised in Houston, Texas. I did my undergrad degree in Europe and then started medical school. I finished up my medical training in Chicago. I’ve been in the EHR space for about 11 years now. I worked for some pretty big consulting companies through 2017 and then started ReMedi Health Solutions, so we are five years in now.
What post-pandemic changes are you seeing with the company and its customers?
When the pandemic hit, we saw everything change, either going virtual or shutting down certain aspects of what was happening in the hospitals. Rightfully so, because of everything that was happening, especially with some of our clients in the Northeast that were being hit with COVID a lot harder than we were down south at that time. What I saw was quick adoption of tools that already existed. I didn’t see anything new come up. I just saw a bunch of people take platforms or technology stacks, put them together, and create what they needed.
Post-pandemic, we assumed that we would have a hybrid model, or even not going back at all to what the norm had been. But I feel like we are getting more back to normal than we had originally anticipated. Some of the workforce wants to be back in the office. They’re trying to get out of the space that they’ve been in for the last 18 months. People are also seeing a different type of productivity versus at home or in the office.
Many health systems are operating under a budget that was created during the pandemic’s bleakest times. Are they reconsidering their priorities or just making it up as they go?
A little bit of both. They were making it up as they went, but now I l feel like the budgets are coming back into the plans they originally had. It is all coming back as if it hadn’t taken that 12- to 16-month pause.
How do you combine the value of a remote go-live with the benefit of having people wandering the halls looking for puzzled or frustrated clinicians who probably won’t open a help desk ticket?
That’s one reason that our virtual model includes a live video feed. It gives the feeling that somebody is there. But your example is why we need some folks to be on ground. We need this hybrid model to engage the physician who we won’t find sitting on a computer or being in a newsfeed, where you could see frustration in any end user. The live feed makes sure that we maintain that emotional connection, but you could have five tablets with one resource supporting all five of those clinics at the same time. The support model will definitely change post-pandemic, and instead of bringing 1,000 resources, you figure out how to bring in a hybrid model of on-site versus remote.
Are you seeing health systems that are worried less about physician EHR satisfaction and instead see the EHR as a way to implement corporate decisions that may take away individual physician choice?
I do see it, but I’m also seeing more physicians getting involved in the administrative side of things, making sure that the right decisions are made for the physicians. That was one of the reasons we came about — we essentially understood both sides of the playing field. It was our job to be that liaison, to help the physicians understand why these decisions were being made from an administrative level. Then on the flip side, help explain to the administrative side of things of why physicians needed certain things.
It is getting harder for physicians to what they need, but it’s also getting more complicated on the IT side as well, where you see both sides of the story.
Are you seeing physician EHR dissatisfaction that is driven by local implementation decisions rather than core product design?
That definitely is one of the reasons. Sometimes what I see, and have seen in the past, is having the knowledge of what the tool can do and how it can drive the efficiency that we are all trying to achieve. Sometimes it starts as simply as that. We’ve seen this across the board. You don’t know what you don’t know. Physicians who I’ve known and worked with have dug into these systems over the last decade and could probably answer any question that a physician might have on what and how they need to do something. They have the inefficiencies in both ways.
When we talk about certain changes, we know there’s a lot that goes behind getting something changed like that. Nine out of 10 times, the physicians will be satisfied, but they just don’t know how to do it. That comes back to, are we talking about training, or upgrades, or new additions? These systems have the capability of doing a lot more than the way the physicians are using them now.
Health systems have said in various recent KLAS reports that they wish their software vendors would take a more active role in telling them how to implement and optimize their systems. Are you seeing more demand for a prescriptive approach that takes advantage of broad vendor experience?
Absolutely, and it makes sense. Why would we not explain these certain milestones or scenarios in the implementation in a better way? We were working with a client 18 months prior to them hitting the switch on the EHR that they had selected. The EHR vendor had a list of items that they were going to run through, but at the end of the day, there was no explanation or details in what needed to be done. Some of these bullet points were engagements that would have taken one or even two months. That is misleading the client.
The consulting company and the EHR vendor have to help them guide and understand the decisions that they are making to maximize satisfaction as a whole for everyone. Not only the end users, but the people who made the decision to bring that EHR vendor in.
Are metrics used to identify users who are struggling or functions that aren’t being used optimally?
We live in a data-driven world. Every metric and every data point that we can grab helps us make a better decision. It helps us explain to our clients, as well as to the vendors, why and how this is happening and how we can mitigate the issue. I don’t look at it as a ticket, but something more detailed than that, that has helped us get success. We have to collect information from one-on-one sessions and at-the-elbow support to get a bird’s eye view and understanding of what’s actually happening.
What changes do you expect to see in the company and in the industry over the next 3-5 years?
Three to five years ago, I thought all of this implementation and conversion activity was going to end. But it seems to be constant due to mergers and acquisitions and systems deciding to replace or upgrade software. We may see the same types of engagements in 3-5 years that we are seeing now. I only hope that we are getting better and better as a whole, the EHR vendors, the hospital organizations, and the consulting companies. How can we make this process better for the actual end users who are going to be using these systems on a daily basis? Can we get rid of the term physician burnout?
Do you have any final thoughts?
We are thankful where we’ve gotten to over the last five years. We’re thankful for all our clients that have trusted us. We are still working with our first client, all the way until our last client. Our firm appreciates that, knowing that we’re giving the value that we said we would. For that, we are thankful for the hospitals that took a chance on us.
So exactly what does the company offer again? No clue what the company does based on the response to the first question here. Looks like a go live support staff augmentation firm? Not sure.
Thanks for reading. ReMedi Health Solutions is a Health IT consulting firm that is mainly focused on EHR implementation and physician adoption. The core service lines include Executive Advisory, Data Migration, Personalization, Go-Live Support, and virtual support services. Our approach is to train end-users in a peer-to-peer fashion, mainly MD to MD.