Executive Watercooler: Projects that Surprisingly Delivered Real Value

The HIStalk Executive Watercooler is a group of hospital CIOs, hospital CMIOs, practicing physicians, and a few vendor executives who have volunteered to provide their thoughts on topical industry issues. I’ll seek their input every month or so on an important news developments and also ask the non-vendor members about their recent experience with vendors. You are welcome to suggest an issue for their consideration.

If you work for a hospital or practice, you are welcome to join the panel. I am grateful for the help of members 

This question this time: What technology project ended up delivering real value even though you were skeptical at first?

The availability of notes and results through the patient portal has been a major plus for many patients, particularly for those with significant health conditions. It’s not perfect yet, especially for people with limited health literacy and for adolescents, where access and/or parental access is often blocked. But with appropriate introduction to the portal and efforts to help engage patients to use the portal, it can be a big help in coordination of care, identifying errors in records, and reducing the need for phone contacts for normal results. 

Clinical pathways. I thought they would get ignored completely. I underestimated our system CMO’s drive to put it on the incentive compensation matrix. Now, it’s still a performance based metric as opposed to actually improving, say, mortality, associated with, say, a CHF admission. But it’s a start, and better than a lot of other things we take on.

Ambient listening scribes.

In the fall of 2019, we began to pilot video visits for our integrated Behavioral Health program. We licensed Zoom for 50 users and spent the time and effort to integrate it with our Epic system. We had a total of six completed virtual BH visits during the three-month pilot period, so we were very skeptical about the adoption of virtual visits. Fast forward three months when the governor announced the COVID-19 shutdown in March 2020. All we had to do was ask Zoom to apply a license increase for our account and then train providers and their support staff on how to use virtual visits to provide urgent medical care and some age-appropriate well visits. We were able to pivot to virtual care in two weeks and were ready to continue caring for patients and families when the shutdown took effect. 

Electronic whiteboards in patient rooms. We implemented them in a children’s hospital and saw an immediate increase in patient engagement with the care team via the whiteboard. Often parents are asleep or taking a break when the team arrives in the room. The ability to leave questions or requests for the team was an immediate win. Accurate reporting of the care team by shift, goals for the day and other information prominently displayed without to log into a portal allowed the less tech savvy easy access to information.

In the past year, we implemented a new AI tool to crawl through all types of data in Epic ( including PDFs in blob server and other external documents) and create a master summary of patient’s clinical history. Goal was to do a better job of exposing critical data from many external sources (unstructured) that might be missed in rapid review of the chart before and during clinical encounter. My organization was asked to be an earlier adopter of this technology. I was skeptical that if there was a tool that could do this efficiently, due to my belief that if such a tool existed and delivered on its promise, every Epic customer in the country would be clamoring for it and that was not currently the case. We proceeding with contracting and have been running the application for about seven months and it is performing as promised, bringing significant value to our clinicians, helping address burnout, and improving the care we are delivering.

Most recent would be ambient listening AI. We are an Oracle Health customer and I had concerns about their solution’s usability and acceptance by physicians. While still not perfect, we are seeing great results and receiving glowing reviews. We are still reviewing and measuring outcomes but expect to be able to tell a very positive story.

We had an AI/LLM project that was focused on evaluating the full reporting ecosystem and identifying redundancies and gaps as well as filling in any gaps. It was far faster and more effective than I originally thought it would be.

One thing that comes to mind is when we rolled out Ninjio cybersecurity training. I wasn’t skeptical of the technology, rather of user adoption. I was surprised how usually cynical clinicians responded to the short and entertaining videos and actually learned tactics to help keep us more secure.