Latest / Becker’s Healthcare - Clinical Leadership Podcast / Dr. Chris DeFlitch, Vice President and Chief Medical Information Officer at Penn State Health

Transcript

Dr. Chris DeFlitch, Vice President and Chief Medical Information Officer at Penn State Health · Becker’s Healthcare - Clinical Leadership Podcast

• 0:00
  - Prepare to dive into the forefront
• 0:02
  of healthcare innovation at our 14th annual meeting coming
• 0:05
  up on April 8th
• 0:06
  through 11th at the Hyatt Regency in Chicago, with thousands
• 0:10
  of industry leaders converging over four dynamic days
• 0:13
  of discussions on crucial topics from health IT
• 0:17
  to executive leadership.
• 0:18
  It's where the future of healthcare takes shape.
• 0:21
  We can't wait to connect with you in person
• 0:24
  and engage in these important conversations.
• 0:27
  - This is Laura Dedo with the Becker's Healthcare Podcast.
• 0:30
  I'm thrilled today to be joined by Dr.
• 0:32
  Krista Fletch, vice President
• 0:34
  and Chief Medical Information Officer at Penn State Health.
• 0:36
  Chris, it's a pleasure to have you on the podcast today.
• 0:39
  - Hey, Laura. Thanks, uh, for having me. I appreciate it.
• 0:42
  - Now, you know, I'm looking forward to our discussion
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  and really learning more
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  and catching up on what you're doing at Penn State Health.
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  I know, you know, it's just such a amazing, um, organization
• 0:51
  and system that's supporting patients in the community in
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  many different ways, and so I'm looking
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  forward to diving in.
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  But before we do that,
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  can you tell us a little bit more
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  about yourself and your background?
• 1:01
  - Yeah, sure. Um, uh, so I'm an emergency physician.
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  I, uh, I grew up in Western Pennsylvania.
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  I'm an unapologetic Steeler fan.
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  Uh, I got my undergrad degree in physics,
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  and my whole family thinks like engineers,
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  and I say that only
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  because it's really, uh, you know, kind of is
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  who I am when I'm, uh, doing things at work
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  or home or, uh, like that.
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  Uh, I, my first connection to Penn State is actually, I went
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  to medical school, uh, at, uh, the College
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  of Medicine in Hershey.
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  Did my emergency medicine residency up at UMass
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  and Worcester, where I got lots of good friends up there
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  and learned lots of good things there.
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  Worked in the community hospital
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  and then came back to Hershey.
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  Uh, now, 25 years ago, I had my 25th anniversary, uh,
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  and I came back only to take care of patients in the ed.
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  I ended up doing a lot of administrative things, though.
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  It was kind of fun just to improve systems.
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  And that's sort of how I've gotten to, uh, informatics, is
• 1:50
  that a system improvement guy.
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  Uh, some people would call me an industrial engineer,
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  want be, uh, I'm big into lean and six Sigma
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  and trust improvement, and how can we do things?
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  And I learned a long time ago,
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  the technology's right smack dab in the middle of it,
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  both in a good and a bad sense.
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  And so, um, since then I've, you know, started a residency.
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  I have, uh, started observational medicine, deployed
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  the EMR at the Hershey campus.
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  And over the last few years, we've become a pretty, um,
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  involved health system, whereas in the last couple of years,
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  we've actually built two new hospitals.
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  We've acquired two other hospitals
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  and have converted well over a hundred ambulatory sites into
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  a standard, uh, EMR platform.
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  And so I obviously can't do that myself.
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  It's our whole IT team along
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  with the informaticists that I have.
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  And, um, it's, uh, it's, it's been a journey.
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  I think one of the fun things though is I still get the
• 2:47
  practice emergency medicine every Thursday.
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  Um, so I still get to teach
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  and I still get to take care of patients,
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  and I still use, use the own systems that I, that I deploy.
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  And, um, I still do some research too.
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  I'm a professor in the college of medicine
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  and I've done a, uh, a lot of granted research in the space
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  of healthcare delivery science
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  and systems, uh, processing, uh,
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  and more recently into, um, advanced decision support.
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  Some people call it machine learning,
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  AI type things, uh, like that.
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  And, um, it's been a,
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  it's been an interesting journey
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  over the last quarter century.
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  - Absolutely. I can imagine. You know, you've seen, um,
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  such an evolution in the healthcare delivery space
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  and then just the whole healthcare ecosystem.
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  Um, and you know, it's cool to hear your journey through,
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  uh, the medical school
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  and just kind of how you've seen your role
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  and your career change.
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  Um, and, and, you know, given all the accelerated change
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  that's been happening in the healthcare space over the last
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  couple of years, and looking ahead, what are some some
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  of your top priorities right now?
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  What do you really keep top of mind?
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  - Yeah, I think, you know, I,
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  I've always been a people person
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  and I think people is really the top things we as, uh, uh,
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  information technology professionals should keep at the top.
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  You know, we all get, you know, enamored
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  by the bright shiny objects or the next new tools
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  or, um, you know, abbreviations
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  that mean different things to different people.
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  Uh, but at the end of the day, it's
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  about the people we take care of.
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  And so always trying
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  to keep the priority, why do we do these things?
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  So making sure the patient is always first
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  and making sure we're caring for the people who are caring
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  for people that is our staff,
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  our physicians, that sort of stuff.
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  And how we deploy technology,
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  how we use technology is actually
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  really snag dab in the middle of it.
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  So, you know, our, our work
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  and priority is to do the best we can for our people.
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  And how do we do that? Well,
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  some big things we've been working on is one standard
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  platform across all of our, um, organizations.
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  So we're almost there. Two is really advancing the
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  communication tools that we have.
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  So we've, um, standardized on a secure texting platform, um,
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  and, uh, have been deploying that now,
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  like you imagine an academic center
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  that's been using pagers since the eighties.
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  Um, it's a heck of a, uh, transformation.
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  So we've, we've actually been able to do, uh,
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  some work there to try to help that.
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  And it's really enhanced the bidirectional communication,
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  if you look at the errors that occur in health systems,
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  and it's about the,
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  the people in the process much more than it is about the
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  technology, but the technology can enhance those,
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  those gaps, uh, in systems.
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  And so, uh, those are some big pieces we're, you know,
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  moving away from old things, you know, getting rid of paper,
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  getting rid of, um, dictations, uh, you know,
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  and actually going to to front end, uh,
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  voice recognition technologies
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  that we have deployed across there, even dabbling in the,
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  uh, generative AI space.
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  And when it comes into those things.
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  And, um, so those are the things that we're really looking
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  to do, is to make things more eff effective and efficient.
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  And, you know, as I tell my team, uh,
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  there's a lot of technology out there.
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  It's a lot of good stuff. Um, but it's how you deploy it
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  and it's how you use it for outcomes.
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  So I've challenged the team to say,
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  if you're gonna do something, let's not do something else.
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  So we've been on a big, uh, waste removal lean approach
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  to our systems where we're going through
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  and looking at the alert alerts and rules
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  and things have been in place for a while, or unused orders
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  or, uh, order sets that have been, you know, uh,
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  not reviewed in the last year and, and,
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  and really getting crisp on, um,
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  becoming lean, uh, in an approach.
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  And that takes a mindset change, uh, in some locations.
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  And, you know, once people realize how you can help people
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  to care for patients
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  and how you can help patients directly, um, you know,
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  that efficiency's there, I mean, you know, one thing
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  that we've seen, like most places have seen is the, um, uh,
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  texting and, um, messaging to, from patients to providers
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  and, and that contributing to
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  long work hours and things like that.
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  Well, we've always had a sort of a, an approach where,
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  you know, there are messages
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  and patient's messages are important,
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  but there's some things that aren't best cared for,
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  you know, with patient messaging.
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  So we did put some limits on the numbers of characters that,
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  that, uh, patients, uh, can send at any given time
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  and put some process and policy around, um, numbers
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  of messages and how we can then
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  redirect them towards a more efficient, uh, area
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  of care rather than texting maybe that, uh,
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  virtual visits will be there.
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  So, we'll, you know, maybe hop in the EMR and,
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  and do an ad hoc, uh, visit, uh, related to it.
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  So it's things like that that I think, um, is
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  where we've been spending our time
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  and I think is gonna make a big difference, uh, in,
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  in the healthcare delivery system as we move forward.
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  - Well, that's fascinating to hear.
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  And you know, I really love your emphasis on the person
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  connection or that personal connection, just keeping that,
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  um, you know, a, as a really important part
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  of the way healthcare is delivered
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  and continues to, um, you know, care for communities.
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  I think you're definitely right in terms of, you know,
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  technology can be really helpful to boost, especially some
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  of the administrative tasks,
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  but then, you know,
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  having those relationships is so important.
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  And too, when you're talking about the texting
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  and messaging, I know that's something that so many, um,
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  physicians, uh, nurses as well as health systems are trying
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  to put those policies and procedures in place
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  and, um, set the right boundaries
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  or funneling systems there.
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  Um, you know, were your teams pretty, um, pretty receptive
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  to some of those changes in, in, you know, patients as well?
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  How were you able to kind of navigate, um, some of
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  that training when you think about, you know, wanting
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  to make sure that patients have access to care,
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  but then to, you know, not, um, overburdening the clinicians
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  with, uh, some of the longer requests or,
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  or things that are, um, you know, not best suited
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  for a text chain and those kinds of things?
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  - Yeah, I mean, it, it, at the end of the day,
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  healthcare is about people taking care of people, right?
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  And sometimes, you know,
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  people are more comfortable in texting formats,
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  sometimes they're more comfortable in video format,
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  sometimes they're more comfortable in person formats.
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  Sometimes they think they need to see a specialist
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  for a primary type activities,
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  and it's about the relationship
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  and communication that you have with them.
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  So it's, it's not say no, it's, geez,
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  it seems you have a lot of, lot
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  of information in this message.
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  I don't wanna lose things in translation.
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  Let's hop on a call. Um, and, and then we have policies
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  and procedures that guide our staff to be able to, you know,
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  um, direct the person to the type of care that they deserve.
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  Not just because, you know, they want to, you know,
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  text here or text there.
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  And, and there is the technology as part of that,
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  but it's really not necessarily the right thing to do.
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  I mean, there's some great things that occur, you know,
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  via telehealth, right?
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  So, you know, we did lots of very creative things
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  during the, during the pandemic with it,
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  and we learned a ton.
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  Now we're applying them in, in real time,
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  and we know that some things you could do really,
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  really well through a telehealth visit,
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  but some things you need an in-person, uh, visit to do.
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  So let's direct them in that scenario.
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  Now we're gonna blur
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  that line even further when we start using peripherals
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  associated with, you know, different technologies to listen
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  to the heartbeat or, you know, looking in the ear
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  or even a retina scan, you know, that you can do remotely.
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  And I think those things are gonna come up
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  and be creative in here.
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  But again, at the end of the day, it's about us taking care
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  of our community people, taking care of people,
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  and, you know, those of us who have the honor
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  and privilege of, of leading healthcare organizations,
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  especially those through technology,
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  have to keep that in mind.
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  And it's, that's really at the
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  end of the day, that's why we're here.
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  - That that's really amazing to hear and think about
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  and certainly, you know, um, right.
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  Makes a lot of sense. Now when you look at, um, the future
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  as well, how do you see Penn State Health growing
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  and evolving over the next two
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  to three years from your vantage point,
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  and especially that fascinating intersection
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  between technology and clinical care?
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  Where do you see it all headed?
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  - Yeah, I, I, it's a great question.
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  Um, you know, we're in a relatively competitive markets in,
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  in, in the area here.
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  Uh, and so, you know, we know that we've, you know,
• 10:57
  got the best outcomes for our heart transplants.
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  We know that our, our, our cardiovascular services
• 11:02
  are the highest quality.
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  We know the cancer services are highest quality.
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  We think that, you know, that's really
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  where we need to focus.
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  Again, it's about the care of the people.
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  You just have to demonstrate that
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  and such so that, you know, the quality focus
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  and, and those activity.
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  And it goes back to some of the communication
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  technologies that we use.
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  It enhances that ability for us to interact here.
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  I, I think it's, it's working, uh, more fluidly as a system.
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  Um, when you acquire two, you know, two other health systems
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  and hospitals and you acquire
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  and you build new hospitals,
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  there are cultural differences in between there.
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  And, and we don't take those for granted.
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  So the transformation of, you know,
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  those different locations as part of our system,
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  it's, it's gone really well.
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  The service line development, this has been spectacular.
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  We've got some great leaders inside of those service lines,
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  but I could see our focus being very much in those, um,
• 11:53
  systemness developments.
• 11:55
  And that's, again, technologies,
• 11:56
  you know, part and parcel of that.
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  So, you know, uh, consolidating, uh, order sets,
• 12:01
  power plans, uh, making documentation more efficient
• 12:05
  for everybody involved,
• 12:06
  but honor the differences that we have
• 12:08
  between our specialties.
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  You know, I'm an emergency physician,
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  I'm not an ophthalmologist, I'm not a dermatologist,
• 12:14
  I'm not a cardiac surgeon, right?
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  Each of those specialties
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  and all the other ones there have
• 12:19
  different things that we have to do.
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  So we have to validate
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  and provide the tools to allow those folks to be efficient
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  and effective while keeping standards
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  across the organization.
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  So that is a, that is tough, um, uh, doable.
• 12:34
  'cause we've done it in a, in a number of different ways.
• 12:36
  Uh, but I think it's, again, it's about standards,
• 12:39
  efficiency and effectiveness.
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  At the end of the day, all those docs
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  and all those nurse practitioners
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  and physician assistants just
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  wanna take care of their patients.
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  Same with our nurses, same with our staff.
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  And I think if we can align the technologies
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  and get rid of, you know, other technology, dudu,
• 12:55
  duplicity, you know, is a challenge.
• 12:57
  Um, variability is a challenge.
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  Localization is really important.
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  And the differences between all those
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  and helping people understand that moving
• 13:07
  to a system is really, really a good thing.
• 13:11
  - I, I agree. You know,
• 13:12
  and having that system,
• 13:14
  it seems like it can be such a powerful tool, um, you know,
• 13:17
  for all organizations and really boost patients.
• 13:21
  And from your perspective, you know, um, I would love
• 13:23
  to hear what is one change
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  or initiative that your team has made over the last year
• 13:28
  or two that's yielded some great results?
• 13:31
  - Yeah. Um, so we talked a little bit about, you know,
• 13:33
  converting to secure texting as a, as a primary platform.
• 13:36
  We talked about, you know, eliminating dictation,
• 13:39
  talked about, um, you know, deploying
• 13:42
  to opening two new hospitals
• 13:44
  and converting two other hospitals plus a hundred clinics
• 13:47
  all within a couple of years.
• 13:48
  That's incredible heavy lifting, right?
• 13:51
  And you can't do that without a great team.
• 13:53
  And so what we try to do, at least in our informatics team,
• 13:57
  uh, is to build a structure by which we can manage
• 14:00
  and handle change, do it with efficiency and effectiveness,
• 14:04
  but do it across the system.
• 14:06
  So we set forth on a structural design for informatics,
• 14:09
  that includes a number of informatics councils
• 14:12
  that focus in on functions.
• 14:15
  And we've, uh, had some, uh, local affinity groups
• 14:19
  that values the local.
• 14:20
  So we have a west shore
• 14:22
  and eastern region, the central region, the northern region.
• 14:25
  And each one of those groups have their own contingencies
• 14:28
  of, of informatic staffing, uh, all come
• 14:31
  to the system, I'll report up through me.
• 14:33
  Um, and so we've tried to set ourselves up
• 14:35
  for the requesters to be able
• 14:37
  to have their questions managed in a timely fashion
• 14:40
  and for changes to occur in the system, uh, that are,
• 14:44
  if they're, they're great ideas from someone, great,
• 14:47
  let's make that a a, a new system standard.
• 14:49
  And so, but you have to have the structure in place
• 14:52
  and you have to have the decision makers
• 14:53
  and empower those decision makers, um,
• 14:56
  to, to move that forward.
• 14:57
  So we built, if you will,
• 14:59
  the informatics governance structure, uh, for the,
• 15:02
  for the system that allows us to do that.
• 15:05
  Um, I'm lucky enough
• 15:06
  to recently have our medical records team start reporting
• 15:09
  to me that's a new, um, opportunity and, and, and task.
• 15:13
  And so we're looking at how can we make that all happen too,
• 15:16
  uh, with that, with that group of people.
• 15:18
  Um, again, really great folks
• 15:21
  and, you know, living in Hershey
• 15:23
  and working in central Pennsylvania
• 15:25
  with all the other things, just some,
• 15:27
  just people are, people are great here.
• 15:29
  I mean, they, they're, they're hard work
• 15:30
  and they really wanna do the right thing.
• 15:32
  And again, what they care about is, you know,
• 15:35
  their family and their patients.
• 15:36
  They care about Penn State and they care about their jobs
• 15:39
  because they know what they do affects
• 15:41
  the patients that we care for.
• 15:45
  - I love it. I, I think it's so important to remember
• 15:47
  and just to keep front
• 15:48
  and center as you were talking about, you know,
• 15:50
  the community that is within healthcare
• 15:52
  and the healthcare system, um, it, it's really cool to hear
• 15:54
  what you're doing at, uh, Penn State Health
• 15:56
  and continue to grow and develop
• 15:59
  and, um, provide additional services.
• 16:01
  So, um, thank you so much, uh, Chris,
• 16:03
  for joining us on the podcast today.
• 16:05
  I, I really appreciate your conversation.
• 16:07
  I think, you know, this is so cool to hear
• 16:09
  how things are going and definitely lots
• 16:11
  of great insights on where you're headed in the future.
• 16:14
  - Yeah. Well thanks. Thanks for you guys
• 16:16
  for having lots at Penn State Health.
• 16:19
  Just talk a little bit about, you know, the people
• 16:21
  that we work with and, uh, the, the people who we care for.
• 16:24
  It's, it's so important to, to who we are as a community
• 16:27
  and who Penn State Health is as a system.
• 16:29
  And, uh, we appreciate.