Becker's Hospital Review

50 CIO / HEALTH IT What will take EHRs to the next level: WakeMed CMIO Dr. Neal Chawla Laura Dyrda H ealthcare providers across the U.S. are leveraging technology to better care for patients and tackle population health issues. e actual care delivery is moving beyond the physician's office and the hospital to in- corporate virtual care visits, remote patient monitoring and more. Care teams are also becoming more integrated to tackle complex patient issues. How can technology improve clinical care and tackle the big challenges in population health? Neal Chawla, MD, chief medical infor- mation officer at Raleigh, N.C.-based WakeMed, joined the "Becker's Healthcare Digital Health + Health IT" podcast to an- swer these questions. Note: Responses have been slightly edited for clarity. Question: What are the big challeng- es you're facing today? Dr. Neal Chawla: e biggest challenge is having real-time or near-real-time commu- nication. We've got great platforms now for EHRs, but we need to get the level on top of that for nonmedically documented care. ere are a lot of phone calls, pages and text messages about the patient and we want to get that all together in one integrated way. en we can get the right physicians, nurses, phar- macists or case managers involved and com- municating with each other. The next challenge is population health. What we're trying to do over the next year or two is getting the right infrastructure in place so we have both the operations and technology working together to manage populations of patients in the fee-for-value world. We are actively preparing for that right now, even though the transition has already begun to happen. e third challenge is stepping down the path- way of trying to figure out predictive analytics and how we move from reactive to proactive data. at's been a challenge to figure out what are the algorithms we need and how we can make them represent our patient popula- tions and then learn and grow. en we can figure out the right interventions that we're able to actually put in place so we can bring them back for clinical transformation. We will then monitor our progress to see if these things truly help our patients live better lives. Q: How will your clinical and technol- ogy teams change to overcome these challenges? NC: We are in the early stages of growing a care management team so we're able to real- ly monitor, track and intervene on patients while they are at home. Before the EHR days, our only opportunity to interact with a lot of patients was when they were in our office to see us. Now we need to really grow our ability to take care of patients when they're not with us. We are growing the care manager skill set to lead us toward remote patient monitoring and having the patients do more from home with blood pressure reading, weight scales, glucose monitors and more. We need more population health skill sets. As I talk about remote patient monitoring from the early days of the pandemic, we are now moving toward telemedicine and we have a lot more tech that is patient facing. But we don't always have the easy patient-facing tech sup- port. During the early days of the pandemic, we were just getting going with telemedicine and video visits. We inadvertently forced our clinics to become tech support to the patient on this brand new technology that they were just learning, too. at was pretty hard. Patients are going to start buying devices that they want to connect and send us data, and they are going to run into tech issues. Figuring out how we provide good patient-facing tech support is definitely going to be a skillset we need down the road. We are also moving into more complex data analytics and looking at data science. We need skill sets to really interpret the data well and statistical skill sets we will need to deliv- er the best care possible to patients and have the best algorithms that can guide us. ose are some of the newer skill sets that we are not fully mature on today that we will need down the road. n What does HIPAA say about employees who become patients? By Naomi Diaz H ealth system employees often become patients of the healthcare entity, creating blurred lines for a health system regarding if and when it can access employees' medical records. But, according to a JD Supra report, HIPAA laws do not apply to employment records held by a healthcare entity. However, individually identifiable health information main- tained or transmitted by a covered entity in its healthcare capacity are treated as protected health information. Here are three things healthcare providers should know about employee medical records: 1. If the records a healthcare entity needs to obtain are medical records of their employee, then HIPAA exceptions would apply. 2. A HIPAA-covered entity is only allowed to use or disclose protected health information for treatment, payment or healthcare operations. 3. If a health system needs to look into an employee's medi- cal record, it must do so for an extremely limited purpose, as listed by the "healthcare operations exception." n

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