Guest Column | April 10, 2018

A Fresh Perspective On HIT

PatientKeeper recently named Christopher Maiona, M.D., as the company’s new Chief Medical Officer. Maiona will serve as PatientKeeper’s senior clinical leader, and brings nearly 20 years of expertise in hospital medicine to the company, both as a practicing physician and as an executive at provider organizations.

“As a physician, Chris knows first-hand how technology can impact the ability to deliver high-quality care, and that if IT isn’t making physicians’ jobs easier, they won’t want to use it,” said Paul Brient, Chief Executive Officer at PatientKeeper.

Maiona took time to answer questions for Health IT Outcomes about the state of healthcare technology today and even takes a look at HIT’s future.

Q: Prior to joining PatientKeeper, you had devoted your career to hospital medicine. How did your experience, both as a practicing physician and as an executive at provider organizations, spark your interest in healthcare technology?

Maiona: My Interest in health IT grew from an underlying fascination with the developing personal computing industry during my college years. I recall my excitement when the first Apple Macintosh was launched. My appreciation for health IT was a natural integration of my passion for medicine and technology.

As a physician, I was an early adopter. I served as the residency liaison for an early EHR coming on line at the time. In subsequent administrative roles, I developed an increasing appreciation for the potential of the EHR. However, as a physician executive I became painfully aware of the challenges relating to the EHR – its negative impact on provider engagement, provider utilization, recruitment and patient experience. To say the least, my hopes and expectations for the EHR were never met by subsequent iterations of the technology. It was these experiences, in concert with a strong desire to achieve the patient care potential of the EHR while addressing the needs of my physician colleagues, that sparked my interest in health IT. My current role is affording me the opportunity to be a part of the solution.

Q: What leadership qualities do you consider to be the most essential as a CMO at a healthcare technology company?

Maiona: The two most essential leadership qualities are vision and empathy. A health IT CMO needs vision to understand where healthcare delivery and technology are going, in order to articulate and affect the synthesis of the two. Empathy is required to effectively represent the professional best interests of physicians as users of health IT. It’s not enough to understand a physician’s workflow; you also have to know what it’s like to spend long days caring for patients, and then confront the time-consuming administrative tasks that go along with it – and how frustrating it is to have that tedium exacerbated by the requirements imposed by many EHR systems.

Q: What do you consider to be the biggest technology challenge that is impacting physicians today?

Maiona: Without a doubt the most pressing and debilitating health IT challenge for physicians today is the user experience.

The root of the problem is found in recent history. With the passage of the HITECH Act and its CMS-authorized Meaningful Use mandates, there was an urgency to develop and implement EHRs to meet governmental requirements. While the underlying intent of these systems was valid, the sentinel design and implementation did not adequately consider the front line users at the tip of the spear: physicians and nurses. For example, it has been widely reported that physicians spend twice the amount of time documenting and feeding the EHR than they do at patients’ bedsides. This has contributed to a disenfranchised user base, the sequelae of which may be seen in survey results associating physician job satisfaction and burnout with EHR concerns.

It is this history (and current reality) that serves as a barrier to physician engagement and adoption of the next generation of EHRs. Even providers who appreciate the underlying advantages to patient care of these systems must overcome their history of disappointment with EHRs and feelings of exclusion from the development process. They need to understand the genesis of these early systems and see them for what they are: a necessary (albeit insufficient) first step toward what ultimately promises to be better, technology-enabled patient care.

Q: What do you consider to be the biggest opportunity for technology to change care delivery?

Maiona: There are new and ever increasing demands on a physician’s time. Time spent documenting and otherwise feeding the EHR is inversely proportional to time spent at the bedside. In an environment where value (defined as Quality/Cost) is king, we have seen continued increases in healthcare cost and have not realized optimal quality expectations. The opportunity – enabled by technologies like AI, CDM, NLP, digital assistants and a simple, intuitive user interface – is to integrate the value mandates from CMS with a stronger bedside clinical role for physicians. The goal is for health IT to become an indispensable tool for 21st century patient care.

Q: If you could tell future physicians one thing about using technology in their practice, what would it be?

Maiona: Technology is the future of medicine. Despite the growing pains and challenges discussed, modern medicine is better for the technologies we employ. Additionally, the rapidity with which medical knowledge is advancing is outpacing our cognitive ability to process advancements in medicine and assimilate the benefits of big data. Technology, as adjuvant to the irreplaceable core skill and compassion of the physician, will help us integrate new data, catch potential errors and omissions before they occur, improve patient care and restore the joy of the doctor-patient relationship. The key role for physicians is to engage in the process. Physicians have more clout than they realize. Their input should help guide development of future technology to meet the needs of the physician while improving patient care. The two are not mutually exclusive!