In a recent Fortune Magazine article, the author posed the questions, “What if doctors used powerful mobile applications to remotely track compliance of their patients’ treatment plans and progress?” “What if they could provide patients with remote access to their expertise, or to other medical knowledge that patients trust?” and “What if doctors kept in-person office visits to a length of time that really allowed for patients and doctors to have longer, in-depth consultations?”  … the answer to all of these questions is that we could deal with health issues in an environment that is much more convenient for the patient and the doctor at a fraction of the cost.

Reading this article made me ask myself these questions: What if UMass Memorial had a dependable, fast, user-friendly IT system that used powerful mobile applications that remotely track compliance of our patients’ treatment plans and progress?  What if we provided patients with remote access to their medical records and our clinical expertise, or to other medical knowledge patients trust? What if we moved away from in-person visits to online visits for most things and reserved outpatient, in-person visits for longer, in-depth consultations? … the answer to all is that UMass Memorial would be a much better place to be a patient and a much better place to be a caregiver.

With the tremendous pace of technology development and the intense pressure to move care to the lowest cost setting possible, it’s only a matter of time before e-visits (online visits with health care providers) become the norm in health care.

Most health care providers are eager to move in this direction, as this infographic demonstrates.  Research shows that 39% of US physicians currently communicate online with patients via email, secure messaging systems, instant messaging or on online videoconferencing. On top of that, 66% of physicians use tablets for medical purposes and more than half the physicians surveyed find that tablets expedite decision making.  Furthermore, 40% of US physicians report that mobile devices decrease the amount of time spent on administration.  With such a wide variety of health care applications and self-monitoring tools available as well as the increasing number of health care portals that allow patients to directly upload their vital signs and statistics to their Electronic Medical Record, we are truly in the midst of revolutionary change.

The technology that allows for e-visits has been around for a while, but it is the change in payment systems that will accelerate our transition to this virtual environment.  Insurance companies have already started to add provider services like Teladoc and DoctorOnDemand to the package of services members receive with the hope that these services will reduce emergency department visits and decrease total medical expenditures for the patients they insure.

UMass Memorial recently created a new company called UMass Memorial Accountable Care Organization, Inc. Like an insurance company, UMass Memorial Accountable Care Organization, Inc., will be accountable for the overall cost of care for approximately 25,000 patients.  But, this new company will fail if we don’t have an IT system that is capable of aggregating all of the clinical data for these patients from across our health care system, allowing us to coordinate care between multiple providers.

Another way to ask my original question is, “What if UMass Memorial doesn’t build a dependable, fast, user-friendly IT system?”  My answer is, that’s not an option, so that’s why we are intensely focused on improving the performance of our IT system.

I believe that fiscal year 2014, which ends on September 30, will be remembered as the year that we finally improved patient flow at the Medical Center (ED boarders are down almost 25%), the year that management committed to listening better to the front line caregivers and instituted thousands of their ideas, and as the year that we made difficult decisions that got UMMHC back on track financially.

Moving forward, our goal is to make FY 2015 the year that we finally improved the dependability, usability and speed of the IT system.  As we search for a new CIO (Chief Information Officer), I have told our interim CIO, Phil Kahn, to focus all of his energy on improving the dependability, usability and speed of the current system.  I have also asked Phil to start updating you about the progress he is making on a regular basis.  As we hire a new CIO, we will specifically be looking for someone that can transform and integrate our many IT systems from a series of loosely knit applications to a virtual environment where patients and providers come together to collectively manage their care. We have made some progress this year in achieving this goal by going live with our new emergency department Electronic Health Record, expanding the data contained in dbMotion and the launch of our patient portal, but we still have a long way to go.

We will build you a dependable, fast, user-friendly IT system and when we do, we will be one step closer to making UMass Memorial the “best place to give care and the best place to get care.”

Thanks for taking great care of our patients and one another,

Eric