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March 4, 2024: In this episode of This Week Health, Bill Russell discusses Meditech’s new advancements in EHR data systems with Dara Bartels, CEO of Mile Bluff Medical Center. They discuss the evolution of their EHR system, highlighting challenges faced with dual systems, interoperability issues, and clinician burden. The conversation focuses on the implementation of Meditech Expanse coupled with Google Health's search and summarization capabilities, offering insights into how it streamlines workflow, enhances data accessibility, and reduces burnout for both patients and clinicians. Throughout the dialogue, Dara navigates through the complexities of EHR integration, shedding light on potential future advancements and addressing the crucial role of technology in revolutionizing healthcare delivery


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Welcome to This Week Health. My name is Bill Russell. I'm a former CIO for a 16 hospital system and creator of This Week Health, where we are dedicated to transforming healthcare, one connection at a time. Today, We have an interview in action from the 2024 conferences, the spring conferences, VIVE in LA, HIMSS in Orlando.

Special thanks to our sponsors, Quantum Health, Gordian, Dr. First, CDW, Gozeo Health, Artisite, and Zscaler. You can check them out on our website, thisweekhealth. com. Now, onto our interview

(Interview 1)   All right, here we are from HIMSS 2024. And we are going to talk some really interesting stuff. I'm with Dara Bartels with Mile Bluff Medical Center in Wisconsin. And CEO. So this is gonna be an interesting conversation about how the EHR has really changed things and people aren't used to hearing that, how the EHR has changed things for a while, it was a challenge, but now we're starting to see some solutions that are freeing up physicians, making the experience better along the way so let's talk a little bit about your EHR journey at this point.

Right now, when COVID hit, we had two EMRs, so with two EHRs. We have a provider system and then we have a hospital system. And so we were using both of those. We had two different systems. And so we had some continuum of care issues. And so then we started looking into one system for all. And what we were doing was scanning information from one system to the other.

So we could share information. Scanning like the old fashioned Like the old fashioned. Put it in a scanner. Print it off one system. Put it in a scanner. Uploaded into another system, one organization.

So it would end up being a, what, a PDF?

Yes. Oh, wow. PDF. So it was hard to search through. You really had to know where to go.

The providers had to get into two systems because that scanning wasn't getting them what they needed. And we went into the adventure of getting one EMR, one EHR with Meditech Expanse. So we looked at that partnership because we had Meditech CS before. So it wasn't a jump for the hospital to go to that.

But we still have a lot of scanning documents that we have in the system. So we've had that for a couple years.

So it's been what, like two years? Two years, yep. But you still have all those PDFs? Yes. So this is where it gets interesting. Yes. This point, the experience hasn't gotten that much better.

I've got to find the PDF, I've got to do all those things. How does it get better for the

clinician? it got better is we went into a pilot program with Meditech Expanse Search and Summarization, powered by Google Health. So we went into that saying, how can we make our providers time better and all of our clinicians, including nurses and everyone.

to get what they needed out of the record. Because we have handwritten notes that are scanned in, we have typed up notes, and so we partner with them, so now we can Google something and it will come up with all the suggested pieces of it. If you have CT, some providers call that something different than CT, so we have issues with terminology.

It's gonna find CT if I hand wrote it. Yes. As well as any other ways that it happens to be in a unstructured I'm sorry, you're CEO. You're good. I'm going geeky on you here. But the unstructured crap Yeah, absolutely.

That sits in the note and all that other stuff and it's able to go through, pull all those things up. And put them into the context in the workflow, I would assume.

Yes. And even if you say, this person has diabetes, it'll go through their labs that are related with diabetes and pull that up for the provider.

So he can see over how many years. So it knows the relations. Yes. So he or she makes a better decision based on the elements that are directly related to that disease state. Right? Because right now they have to funnel through. You can imagine, we get a record from another hospital they went to, or a specialist, and you've got to go through all the demographics, you've got to go through all their history, you've got to go, which you may already have.

And so you can easily go through the Google search function that's embedded in Meditech and our product to be able to do that.

Yeah, so a lot of the interoperability that exists today, this is a little secret that people don't know, it's still these PDFs being passed around from one health system to another health system.

Yes. But when it comes to you guys are able to Through Meditech Expanse with a Google foundation to it, able to search Those records that have come in from other health systems. that's a huge challenge because you don't control the quality of the other health systems record at all.

Right. They can document in any way they normally do. Yep.

Any, former fashion is what we found is what we mean for in one part of the record is completely something different in a specialist part of the record. So we've struggled with that, even internally. Sometimes you'll download a new record into a different tab in our Metatech Expanse.

And so as we were going through learning MetaTek Expanse, people were putting things in different places because it means something different to each provider. So it depended on who they talked to before we got the standards and protocols in place. And so now we don't have to worry about that. And we would have providers that would go through hundreds and hundreds of pages.

Because they weren't confident. So they'd flip through and catch, oh, I want this. And that's what they'd make their decision on. And so now they can do that in

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  📍 📍 So you sound like a CEO who has sat down with a few clinicians and talked through it. Talk through how they're experiencing it and how, the feedback that you're getting around it.

It's very interesting when you go up against, sometimes it feels like that, a group that has a thought of what they want and how they believe they can get it. So when we started going through this process, as I sat outside of it a little bit, I was able to come in when we started looking and doing some demos.

The providers and nurses were trying to find the loopholes, right? There's got to be a search function that doesn't work. Let me try this. Let me try that. And in the partnership, when we found those things, they would go back, Meditech, Expanse, and Google would go back and solve those for the providers.

And so now we've went live as of January, and so we've really seen where a lot of those things are solved. Though there are some gaps. It's pretty exciting.

Yeah, that's interesting. I, part of me thinks Google as well as others are starting to make advances in generative AI. Now, we're searching all those records and what not. But you can also see other tools, not just the search functionality, but other tools start to get integrated into the EHR and where it might take

us. Yes, lot of things that when the came alive, it was a lot of burden.

I'll just, as I said, a lot of burden. And this is really the first project that I've been involved in that really takes the burden off the patient. Because everything we've done with EHR has also burdened the patient. You go out to the portal, you go make sure your records are there. We burden them a little, along with the providers and clinicians.

This is the first tool I've seen that is really taking that off of both the patient and the provider.

I was doing a panel discussion once and There was a woman in the audience and she said, Are you a CIO for a health system? I said, yeah. She goes, here's the problem I want you to solve.

And her child had a chronic disease and she had these three binders. And they were massive binders. She goes, I have to take her to a different doctor. Every six months or so, I go to a new doctor. And I bring in these binders. And she goes, I am scared to death that they're going to miss something.

I don't think they're going to read all these pages. And what you're describing is, Alright, let's go ahead and scan them all in. And then we can search them and find those things that are relevant. And, it's still not perfect because we don't want to have to scan. It would be nice if those records flowed and that's But, at this point, just knowing that all that information was digested, looked at, and we found them relevant things to care for her daughter would be amazing.

It'd be amazing. And you're right, the next step is how do we get it out there in a depository area that we can just reach into and grab instead of scanning. I don't know.

We're not sitting here with the Meditech Expanse product manager, but the next thing I would say to them is, Hey You have this great capability to search all these things.

It would be interesting if we could search those things and then move them into discrete data elements. Yep. Move them into, some of the reporting and some of the other things.

Yep, and that's where we keep talking and expanding on what that would look like. So we don't have to then do any manual intervention with that piece.

But it's exciting. we've really seen what it's gonna do for burnout. For both, really, the patient all the clinicians, fantastic.

Yep. Tara, thank you very much for your time. Thank you.


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