Paperless offices. Instant access. Electronic health records. Fifteen years ago, these were little more than amusing catchphrases bandied about at medical conferences by technology professionals claiming to have seen the future. Few believed they would become an everyday reality or that health information management was to be seen as a competitive advantage.
Today’s medical technology leaders, including Dr. Ravi Nerella, who serves as chief medical informatics officer at Martin Health System, are now reordering their priorities and reexamining their health-record processes with a key goal in mind: to embrace the best EHR adoption strategies in order to streamline their information management systems.
As a young boy, Nerella was enthralled with technology, clearly remembering when he first saw Apple II and Commodore 64 computers. Marrying his love of biological sciences, healthcare training, and his fascination in “all things technology” was a natural course as Nerella continued into the medical arena.
“My father is a pediatrician, and he was the inspiration for me to enter the field of medicine,” Nerella says. “I also enjoyed determining how technology could help improve people’s lives. Eventually, putting together the two components seemed like a perfect fit.”
For nearly nine years, Nerella worked as a physician at Mercy Clinic in Springfield, Missouri, until he began to explore the EHR landscape. “When I working as a clinician in Missouri, the hospital system was implementing an EHR, and I stepped in as a physician ‘champion,’ which was someone that supports the technology,” Nerella recalls. “I was part of the rollout. I really enjoyed helping my fellow physicians make the transition and understand the implications of the technology and its role in patient care.”
“My father is a pediatrician, and he was the inspiration for me to enter the field of medicine.”
Two years ago, Nerella moved into a full-time nonclinical role at Martin Health System, serving at the organization’s CMIO. As such, Nerella leads and facilitates clinical advisory groups in the design of clinical systems to support excellence in patient care and research, while providing clinical insight to EHR optimization and integration throughout Martin.
Despite the responsibilities, Nerella points out that the CMIO role continues to evolve, as does the technology that the role oversees. “Initially, it was more about helping health systems implement their EHR systems, and now it is really about leveraging the technology to get hospitals and physicians to become more efficient and cost-effective,” he explains. “It also involves evaluating data and analytics and looking down the road to determine what’s on the horizon.
At Martin, Nerella is working on optimizing order sets in the EHR system. Before the EHR evolution and computer technology, order sets were done on paper. A physician would write down specific patient-care orders that they wanted the nurse or another healthcare practitioner to execute. Members of a healthcare organization would sit down and evaluate the order sets needed for a particular condition.
“It became a checklist of sorts, whereby physicians didn’t have to remember every single nuance of a condition and the appropriate corresponding order set,” Nerella says.
While the translation to EHR has streamlined this information, sometimes order sets are blindly replicated off of paper—putting what’s on paper into the computer system. However, at Martin, Nerella is working hard to educate others about the built-in functionality on the EHR back end, which will make order sets even more efficient.
“We build these order sets for the patients’ best care, but we are also leveraging the technology and functionality of the EHR in the back end,” Nerella says. “This helps physicians be more efficient and understand the implication of certain downstream processes for other ancillary staff.”
Healthcare guidelines also change on a fairly regular basis, so Martin reviews order sets regularly to make sure they reflect current guidelines.
“It’s an ongoing process, and we have to make sure we are meeting all of this criteria to provide the best care for the patient while also meeting compliance issues,” Nerella says. “There is a constant evolution in technology within the healthcare industry. There are new technologies and versions that will allow us to provide better patient care than we currently are able to.”
In looking at technology, Nerella admits he does so as more of a realist than a visionary. “I like to look at what it really means to me or someone who would be using it,” he says. “We need to look at the real-life implications. There are a lot of questions regarding the future of these technologies, and how does it all fit together as we strive to take care of our patients better?”
While such questions will no doubt be ongoing, for Nerella and Martin Health System, the answers are just around the corner.