With each issue, Trib+Health brings you an interview with experts on issues related to health care. Here is this week's subject:
Kirk A. Kirksey is vice president for Information Resource at the UT Southwestern Medical Center and created the center’s Information Resources Department. Kirksey is an expert in information technology and an adjunct professor at the University of Texas at Dallas' Alliance for Medical Management Education.
Editor's note: This interview has been edited for length and clarity.
Trib+Health: Have you seen recent increases or changes in the role technology plays in healthcare, in regard to connecting with patients and improving patient care?
Kirk A. Kirksey: I’ve seen a lot of changes really in the last five to 10 years, especially with the web technology becoming so prevalent and people accepting the web. That is more and more common. People are really almost demanding connectivity to their banking records, their insurance records and now their healthcare records.
Five years ago, 10 years ago, that wasn’t the case but now connectivity by a patient to their electronic medical records is almost expected. People, especially in an urban area, really expect that to be there.
Trib+Health: How do you think that benefits the patient as well as the healthcare provider?
Kirksey: There’s really a lot of benefit on each side. We’ve allowed access for our patients to their electronic medical record for many years. We have about 87,000 registered patients. We’re doing a study right now. The additional data shows for congestive heart failure patients, their outcomes may be better if they stay connected via the web to their electronic medical record. Our next study will try to narrow down why, but there could be several reasons.
One is they take their medicines better. They can go online and they can request refills for their prescriptions, and we know in the old days they had to call on the phone and they’d be on hold for some time. But now they can request refills very, very quickly. We see a lot of demand for that.
Another reason is that they have a secure link to their physicians to ask their physicians questions and get answers back over a very secure link.
The third reason is that they get access to their results. If you have a lab test, in some cases you’ll see your lab results before your doctor will see them. I think the engagement there, people are doing more research about their own well-being. When they have that information, it spurs them to do more and really take more accountability for their own healthcare.
Now, on our end, we don’t have to deal with as much paper. We spend a lot of resources dealing with paper, moving paper around, trying not to lose paper, making sure paper was readable, and all those problems really are going away.
Trib+Health: How has UT Southwestern Medical Center incorporated technology into its day-to-day operations to connect with patients?
Kirksey: We have very extensive electronic medical records. It’s pretty unusual here because we own both clinics and hospitals, so our patients – my parents, for example, who see their doctors in our clinics– their electronic medical record is integrated if they go into the hospital.
Now that’s not true in the community. You may see one specialist for one thing, go to a different office and then go to a different hospital. So consolidating your record under that scenario is very, very difficult.
Inside our facilities we give our physicians and our clinicians several ways to access the patient’s record and show the patient their record. For example, they can access it with a normal computer, but many of our physicians access it with a tablet or a phone. They will use that to educate the patient, so they may show the patient their X-ray, or they may show the patient their lab results and say “this means this, these are the implications for you.”
And again, we have something called My Chart, and that’s the patient's personal web portal into their medical records. We have a health desk they can call if they need support. We try to support all of our patients as much as we can and encourage them to use their electronic medical record as much as possible.
It’s also very invaluable for people that are at home taking care of patients. This is kind of a forgotten population, but as baby boomers age, their children will be taking care of them. It’s really invaluable for people taking care of elderly patients or infirm family members.
Trib+Health: How could this model be applied to other medical centers and hospitals in the state?
Kirksey: We have three designations, one is the one you mentioned, “Most Connected.” Another one is “Most Wired.” That’s a different organization. But the one I think we are most proud of is we are a Stage 7 hospital. There’s an organization called [Heath Information Management Systems and Services], which is our professional organization, and it gives you that designation. That designation means you’ve reached the highest level of automation in healthcare.
To reach that designation, you’ve got to do things like allow your physicians to do ordering online. You’ve got to make sure that your medication loops are what are called closed — that the patient is getting the medication they ordered, and you can account for all those medications. So identifying the patient with bar codes on their bracelets and things like that. We’ve increased patient safety, especially in terms of medication errors, because the technology forces a process where, every step of the way, the identity of the patient is checked and the appropriateness and the correctness of the medication is checked.
Trib+Health: Is there a particular new technology or technology trend that could potentially be used in hospitals that you’re excited about?
Kirksey: Yes, I am. That is the trend of analytics. Up to now, we’ve used technology really to control workflow. We don’t have just one system. We may have 30 or 40 clinical systems doing different things. The big trend in healthcare now is to take all of this data that we’ve been capturing and do very sophisticated analytics, you know, to test a hypothesis to say if we change an expected mother’s appointment schedule, will it affect the outcome of the baby and the mother. Really from some scientific, operational research to using very, very sophisticated analytic tools.
It’s big data. It’s a lot of data and soon we’ll be doing that with genetic information as well. It’s very exciting because it’s a lot of new technology, but it really holds a lot of potential for patient safety and efficiency that we haven’t had before in healthcare.
Trib+Health: In what ways do you think analytics would be most beneficial to patients?
Kirksey: I mentioned one example here. We are doing a study to try and figure out if being engaged with your electronic medical record via the web improves your outcomes. If we find that’s the case, we’ll know the patients who don’t use their electronic medical record, and we can train them better. It may be worth it to go out and buy the patient a computer, if it keeps them out of the emergency room, it lowers expenses and it improves their outcomes. So when we find things like that, and we perform what are called interventions, then those will all be based on data as opposed to opinion. They’ll be evidence based.
Trib+Health: What are some other things that medical centers and hospitals can do to be more connected with patients and their families?
Kirksey: There are trends for wearables, and one big trend now is, you know you don’t want to keep a patient in the hospital too long. It’s bad for the patient. It’s expensive, so you really want to get the patient out of the hospital, at home, in a comfortable environment. But to do that we need more monitoring at home, with instruments that put out a digital signal, like a digital scale or a wearable or a Fitbit or a blood pressure [monitor.] So we can do that monitoring at home rather than have them in the hospital. Healthcare is really moving that way, to really connect to information that is not strictly gathered inside the hospital.
Right now we are really focused on gathering only information that we generate. What I think a big trend will be is to incorporate all of this other data, these wearables. If patients go to different doctors that have different electronic medical records, those will be interconnected and interoperate. So interoperability and just capturing information from sources we don’t do now to give a more complete picture of the patient’s condition, I think, is a big direction in healthcare now.
Trib+Health: If the roles are reversed, what are some things patients and their families can do to be more connected with their doctors and medical centers?
Kirksey: We believe that when they select a doctor, we believe that the electronic medical record is becoming a competitive tool. These days I would not consider a doctor for my parents, let's say, where I couldn’t have access to their records. That’s one thing a patient could do.
Another thing, when they have access to their records, it’s really important they pay attention and make sure that if something looks funny, errors can still occur. So it’s learning how the electronic medical record works, looking at what some of the values mean and understanding the workflow and the process of their own disease or condition, whatever that may be.
If they’re not connected, learn how to get connected. It’s very, very easy. Very simple.
This isn’t the case for everyone, but in our case I could look at my electronic medical record on my cell phone, on my iPad or my iPhone or my Droid phone. Now that’s a feature of our system that not everybody has, but that’s where it’s going. You’ll be able to get a picture of your electronic medical record wherever you are.