NYP CIO Daniel Barchi: How mobile helps us expand our reach

This fall, NewYork-Presbyterian Hospital will debut a virtual service providing digital follow-up appointments which will allow patients to avoid in-office visits.

It is one of four new services announced earlier this summer as part of the NYP OnDemand initiative, a digital health platform aimed at boosting and expanding patient care while providing extended clinical expertise access to peers in the healthcare network. The suite of services was developed by NewYork-Presbyterian’s Innovation Center, which launched in 2014.

Much of NYP’s mHealth efforts are done in collaboration with Weill Cornell Medicine and Columbia University College of Physicians & Surgeons. NYP OnDemand already is providing patients a digital second opinion pathway via quick and easy access to clinical experts without having to make an in-person appointment. Additional services feature interhospital digital consults with physicians in NYP’s regional network, and digital emergency and urgent care via real-time video interactions with clinicians following triage and screening.

In a recent interview with FierceMobileHealthcare, NYP CIO Daniel Barchi (pictured) discusses the provider’s mobile strategy, as well as the hospital’s collaboration with New York City technology and startup companies as part of its InnovateNYP: Pediatric App Challenge initiative.

FierceMobileHealthcare: What was the process for mapping out initial services for OnDemand?

Daniel Barchi: About a year ago we recognized that our services, as well as other digital health offerings elsewhere, were fragmented and none had a fully comprehensive set of services that could work in tandem. We wanted to find a way to expand access to our physicians at Weill Cornell Medicine and Columbia Doctors and so we developed the NYP OnDemand suite to be an enterprise-wide initiative that will allow us to deliver the best comprehensive, quality and compassionate care. NYP OnDemand will allow our providers to gain new patients, as well as see more of their current patients, while also reducing the number of steps a patient will need to take to receive NYP’s care.

As more patients use digital health services, our hospital can focus even more on the patients in the physical space. For example, when more patients have virtual emergency room visits, there will be reduced crowding and wait times. Additionally, open communication and access to information can improve the patient experience and help patients better manage their own care, leading to improved health outcomes.

FMH: What challenges do you anticipate with such an emphasis on digital?

Barchi: This is a significant change in the way we provide care. Both patients and providers will require strengthened technological infrastructure, for example; good internet connectivity, general video connection, software and a stable network, as well as computers with functioning cameras and speakers. Doctors must consider how a virtual interaction might change every step of the visit, from greeting to examining to following up to documenting. Workflows must be modified. Staff must know how to respond when there’s a tech issue. And lastly, full adoption will require a shift in culture.

Some patients and providers still prefer in-person medical interactions; however, in-person consultations shouldn’t be viewed as opposites--they work best together.

FMH: How have patients responded?

Barchi: There is a perception that digital health will only be embraced by younger, technically savvy patients. In fact, in our first week of piloting digital ER visits, we had a 21-year-old and an 81-year-old as sequential patients. Both came in for suture removals, both were in and out of the emergency department in under 30 minutes, and both raved about the experience.

FMH: What will come next in terms of apps and services?

Barchi: In the near future, we will initiate a broad launch of our digital emergency room visits, expand our telestroke program to all of our regional hospitals and expand NYP OnDemand Second Opinion to international patients.

FMH: What was the impetus behind InnovateNYP?

Barchi: Since the opening of our Innovation Center, NYP has collaborated with NYC’s technology and startup community on developing technology-driven health solutions for clinicians, patients and their families. We held our first Hackathon that spring and the results were incredible. It was at that time that we fully realized the importance of engaging the community. We chose to focus in on pediatrics for the most recent challenge in an effort to empower pediatric patients, their families, and their providers through technology.

FMH: What are top challenges providers face with using mobile tools?

Barchi: There are so many unique ways that technology is being developed that our challenge is not in finding new digital health solutions, but in deciding which opportunities to focus on. We have to be careful not to lose sight of our commitment to patients in our beds today while we explore the new technology we may use in the future. One of the hardest decisions we have to make is to say “no” or “not yet” to a promising company or idea in order to focus on our daily work and a focused portfolio of new technology.

We are often asked if security or patient privacy are a barrier to adoption of new technology. In fact, they are a help, because our obligation to safeguard patient information is a good counterbalance to rapid technology adoption. Because our IT security team puts even small, cutting-edge technology through rigorous testing to ensure patient data is secure, we avoid accelerating the adoption cycle ahead of what is best for our patients.

Editor's Note: This interview has been edited for clarity and length.

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