Advice From The Co-editor of a Guide to Innovating with Health IT

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Dr. Lyle Berkowitz is the associate chief medical officer of innovation for Northwestern Memorial Hospital and the medical director of IT & innovation for Northwestern Memorial Physicians Group (NMPG) in Chicago. He is also the founder and director of the Szollosi Healthcare Innovation Program (SHIP), president of Back 9 Healthcare Consulting, and the founder and chairman of healthfinch, a healthcare software company making “Doctor Happiness Tools.”

He has been listed as one of HealthLeader’s “Twenty People Who Make Healthcare Better,” Healthspottr’s Top 100 Healthcare Innovators, and Modern Healthcare’s “Top 25 Clinical Informaticists.”

Berkowitz co-edited the new book Innovations With Information Technologies in Healthcare, a collection of real-life examples of innovations with EHRs and Health IT told by the physicians and healthcare leaders who spearheaded them.

What do you hope people get out of your book?

We created the book to educate and inspire our healthcare workers to be able to realize they can and should think innovatively about the information technologies that are currently using within their organizations as well as information technologies they might see elsewhere or private healthcare and think about how they might bring them into healthcare.

We actually created a fake family, the Martinez family, and we introduce you to the Martinez family, we don’t just say ‘this is a 52 year old male,’ we say what type of job he has, what his belief system is, how he relates to doctors. We worked with a persona expert to create this family, mother, father, two children and a couple of their relatives.

We asked our authors, ‘how might this family experience your innovation?’ The start of every chapter is literally a story about the family and how they experience the innovation. Many of the authors are physicians, other providers of care, certainly healthcare experts.

In every chapter you have to start out with what the essence of your innovation is and then where does it start? Take us through the journey of how it went from an idea to reality, tell us about the mistakes you made and the lessons you learned, tell us what’s going on now, what benefits you see and tell us what you’re thinking about doing in the future. Using that structure, every author was able to put in their own words a very nice explanation of what they’re doing in their organization.

What areas of innovation does it cover?

In section one we talk about electronic medical records, and that you have an electronic medical record that explains what you do with that technology in innovative fashion. Everything that was written in that chapter could be done in almost any electronic medical record.

In the second section, we talk about telehealth, things like e-consults, e-visits between a doctor and patient, as well as big uses of telehealth such as e-pharmacies, e-pharmacists that were used to support a rural hospital, as well as teletranslators, which is a couple organizations coming together to bring all their translators essentially into a big unit together so they could be spread across all the hospitals.

In the final section, we’re talking about advancing technologies and ideas like gaming, why gaming works, why it’s so popular and a variety of examples of how it’s being applied in healthcare in both making patients more comfortable as well as training doctors in simulation labs and solving medical problems.

Did you learn anything new along the way?

There are a couple of key concepts that came through. One was that most innovation came from the bottom. It started with a passionate provider.

The example I often use is Peter Pronovost’s checklist. He created a checklist in the ICU as to the five things you have to do when you put an essential line in a patient. You do these five things, it reduces the risk of infection basically to zero. But doctors aren’t following that checklist, they were supposed to do it, they forget a step or two. When they follow the checklist on paper, it had a greater effect, but it’s even more efficient if you can translate that concept into the information technology that is ubiquitous throughout the field and ICU in particular.

One of the chapters in the book talks about using a checklist for assisting with ventilator management, and incorporating that in the work flow is just very well done, such that a ICU nurse could look up at a bank of monitors and quickly see the colors green, yellow, red, when the checklist was completed and who needed additional services based on the checklist. Instead of doing it all on paper, it’s integrated into the information technology system, they were able to make it extremely easy to use and extremely efficient.

What’s some of the advice you would give to providers?

Every organization has a variety of politics and culture and technology and systems that make it unique, so you can take the general gestalt of the innovation and the lessons learned along the way, but then you have to apply into your own organization. It’s never as easy as just flipping a switch and converting from one place to another, but this gets you 90 percent of the way there and these are templates to figure out that 10 percent of the fine-tuning that will make it work for your organization.

Most of these innovations were one-shot wonders, meaning that the physician champion who was involved and just inherently knew what to do and was able to see it through, and their job was to continue seeing it through which does not create more innovation. Many of these innovations were born and continued to thrive by having a specific champion who continues to work with that innovation.

What are you reading this summer?

The Bizarre Double Life of Dr. William Stewart Halsted. He’s essentially the father of modern surgery. He was an innovator in his own right in the late 1800’s. He was a champion of antiseptic technique and anesthesia and experimental surgery on animals before humans. He also was one of the giants at Johns Hopkins who created the whole concept of residency. I read this book, I realized this guy is an innovator and using all the techniques and concepts of innovating in the world and what he did really changed the face of medicine as we know it.