Miami Children's CIO Ed Martinez: Telehealth, smartphones vital to patient engagement

Miami Children's Hospital Senior Vice President and CIO Ed Martinez believes that much of the future of patient care is tied to an ability to reach patients through telehealth and mobile solutions. He was named the College of Healthcare Information Management Executives' Innovator of the Year in 2012 for leading the development of an eHealth initiative that sought to boost patient engagement while simultaneously improving workflow processes, all of which was part of a larger effort to serve underserved communities.

"We're able to provide telemedicine technologies fronted with engagement and wellness software, which allow for a doctor away from the office," Martinez (pictured) told FierceHealthIT at last week's Healthcare Information and Management Systems Society's annual conference in New Orleans. "That's where I think a lot of care is going."

Martinez also elaborated on the importance of patient engagement, and talked about some of the challenges his facility faced in implementing new technologies.

FHIT: Describe how you are engaging your patients and what their response has been.

Martinez: The reality is, everyone carries a smartphone, and smartphones are the future. We've been focused on eHealth mobility solutions. We have a suite of applications and we're continuing to deploy more applications. We're now also starting to embed that into a framework of applications that tie back to our electronic medical record.

I've received very positive feedback from the patients, as well as some employees, which routinely you would think would be a point of pushback. Now, [our employees] are doing less paperwork and focusing more on patients.

For example, one of the things we strive for is making sure that patients have all of their documentation before they get to the hospital or clinic. Yes, we can do that on our patient portal, but patients now want to do it on their mobile devices. Anything that engages them so that by the time they get to their physician encounter, all that's left to do is see the doctor. This is not rocket science. It's being done in every other industry in the world. It's only innovative in healthcare because no one's ever used it in healthcare. It really just boils down to changing and adapting workflows.

FHIT: What are your thoughts on some of the initial backlash to the patient engagement requirements in Stage 2 of Meaningful Use?

Martinez: I don't understand it. This is just good customer service. You want to treat a patient like a customer, and if you do so, then what's all the hoopla about? You want to make sure you engage your patients well before they show up to your hospital or office for a couple of reasons: 1) They are more educated of what's going to be expected of them; and 2) They absolutely know what's to be expected after a procedure. You're creating an educational before-and-after component, and more importantly creating an engagement that shows the patient that they're not just a number and that we want to help them better.

This is something you would want to see if you were a customer in any other business, so what's the difference between healthcare and any other business?

FHIT: You mentioned that technology adoption sometimes can be a point of pushback with some employees. What challenges have you faced from staff members to such efforts?

Martinez: I can break that down into three segments: We have clerical staff, clinical staff and medical staff. The clerical staff predominantly embraces the technologies and the workflows. The clinical staff shows some resistance, depending on how it impacts their workflow, but ultimately accept it, too. The medical staff, however, continues to be the most challenging of the three because physicians work how they want to work. That's their behavior.

We've introduced new guidelines and bylaws in medical exec committees that are changing the way we practice medicine and physicians have to adapt. That said, we still have some older physicians who have been around for a long time, and it can be very hard to work with them in these scenarios.

We're catering to them and, unfortunately, that's probably going to continue to happen for the next five to 10 years.  Once they retire, I think that the future's going to be different, but right now we have to deal with them and try to work around them.

The truth of the matter is, physician adoption for those guys that are older likely isn't going to happen.

Editor's note: This article has been edited for length and clarity.

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