For someone who claims not to be a technology geek, pediatrician Carol Steltenkamp certainly spends a lot of time with technology.
She's a chief medical information officer, co-chair of Kentucky's health information network, head of the Kentucky Regional Extension Center, and a board member of HIMSS. She caught the IT bug, from a business perspective, while supplementing her medical training with an MBA from the University of Kentucky, just as UK Healthcare was starting to adopt clinical computing.
"I started to see that IT could improve care," she says. Taking on the role of physician champion led her eventually to the CMIO post. Currently she's involved in almost every aspect of getting her state wired for health care delivery. She finds it exciting-as a physician, a business person, and an IT person-that the growing use of health information technology is converging with the trend toward value-based reimbursement. "If you've done the right thing for your patient, you get paid, and IT helps you do that," she says. "That's what gets me out of bed happy in the morning."
On Selling the EHR
When you go to change how someone does their job, there's always going to be resistance. For me, [the advantage of an EHR was] having information available that hadn't been before-what other physicians were thinking, what all the patient's prescriptions were. Yes, it was easier to pick up a piece of paper, but it wasn't easier to find the chart, and it certainly wasn't easier to work from home. Now I think we're seeing a shift among physicians.
Physicians are not resisting the EHR as such, but we're really starting to feel the bumps in the road. We've gotten past, "Oh, my goodness, you're going to make me use it?" and on to, "Why can't you make it do more?" That's a great problem to have. Now my request would be to ease [physicians'] pain in meeting the regulations. They seem reasonable, like motherhood and apple pie. Who doesn't want to do good care? But for most clinicians, it's making the time. Vendors are strapped for staff and time, too. If you have a 700-bed hospital and a two-physician practice who both need an upgrade and are three hours from the closest airport, who are you going to help?
The challenge to the IT professional is to facilitate the physician's workflow. Data-gathering shouldn't drive the build; it has to align with the workflow in a way that you can extract what you need. We'll have to have some mixture of templates and text, and the ability to tag certain comments in the text. Moving to ICD-10 and other standard ontologies and languages will help.
This profile originally appeared in Health Data Management Magazine.
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