iHT2 Health IT Summit in Austin 2012 – Lyle Berkowitz, MD, Associate Chief Medical Information Officer, Northwestern Memorial Hospital, Keynote Presentation: "The Healing Edge: Where Innovation Meets Information Technology" Lyle Berkowitz, MD, FHIMSS, is a Primary Care Physician and healthcare innovator who was named one of the "Top 20 People Who Make Healthcare Better" by HealthLeaders Magazine and is one of Healthspottr's “Future Health Top 100”, a list of top innovators and change agents in healthcare. In addition to practicing Internal Medicine, Dr. Berkowitz is the Director of Clinical Information Systems for the largest primary care group in Chicago, the founder and leader of the Szollosi Healthcare Innovation Program, and the President of Back 9 Healthcare Consulting. Past experience includes work as the Medical Director for two publicly traded companies – an electronic medical records vendor and a global eBusiness consulting firm. Dr. Berkowitz is a frequent national lecturer on healthcare innovation and information technology, and his "Change Doctor" blog was recently named one of the Top 50 Healthcare IT Blogs. He a contributing author to the American College of Physicians' book "Electronic Medical Records" and is on the Editorial Board of Healthcare Informatics magazine. He is a Fellow in the Healthcare Information Management Systems Society (HIMSS), is part of the Advisory Board for the Association of Medical Directors of Information Systems (AMDIS) and serves on the Board of Directors for the American Health Information Management Association (AHIMA) Foundation.

1. THE HEALING EDGE
The Power of Combining Innovation + HIT
Health IT Summit in Austin
December 6, 2012
Lyle Berkowitz, MD, FACP, FHIMSS / Lyle@DrLyle.com / DrLyle.com / @DrLyleMD
Associate Chief Medical Officer of Innovation, Northwestern Memorial Hospital
Medical Director of IT & Innovation, Northwestern Memorial Physicains Group (NMPG)
Associate Professor of Clinical Medicine, Feinberg School of Medicine, Northwestern University
Founder and Director, Szollosi Healthcare Innovation Program / TheShipHome.org
Founder and Chairman, healthfinch / healthfinch.com
The Healing Edge: The Power of Combining Innovation + HIT / Lyle Berkowitz, MD / AMDIS 6.28.12

2. I’m a physician.
And
… an informaticist
… an innovator
… an entrepreneur
The Healing Edge: The Power of Combining Innovation + HIT / Lyle Berkowitz, MD / AMDIS 6.28.12

3. The Innovation Process
Discover
Investigate new ideas, programs, technologies
Incubate
Move from ideas to pilot programs
Accelerate
Move from pilot programs into standard operations
The Healing Edge: The Power of Combining Innovation + HIT / Lyle Berkowitz, MD / AMDIS 6.28.12

4. Where to Start?
Experimentation vs. Planning
The Healing Edge: The Power of Combining Innovation + HIT / Lyle Berkowitz, MD / AMDIS 6.28.12

5. LYLE CHRIS
BERKOWITZ, MD MCCARTHY, MPH, MBA
The Healing Edge: The Power of Combining Innovation + HIT / Lyle Berkowitz, MD / AMDIS 6.28.12

6. LET ME TELL YOU A STORY
ABOUT THE ROCKY SPRINGS HEALTHCARE SYSTEM
The Healing Edge: The Power of Combining Innovation + HIT / Lyle Berkowitz, MD / AMDIS 6.28.12

7. Chapter 1
The Healing Edge
• Tell me a Story: Voice of the Innovator +
Innovation Personas
• Standardized Structure:
+ What, Why, How, Results, Lessons
Learned, Future, and Conclusion
Information • Three Sections: EHR, TeleHealth, Edge
Technology The Healing Edge: The Power of Combining Innovation + HIT / Lyle Berkowitz, MD / AMDIS 6.28.12

8. Chapter 2
Mad for Method
Evidence-based human-centered design
Innovation Observation Synthesis
+ Ideation
PDSA
Prototyping
Pilot
Information Others…
Technology The Healing Edge: The Power of Combining Innovation + HIT / Lyle Berkowitz, MD / AMDIS 6.28.12

9. Computers are
really good at
being
computers, but
they are lousy at
being paper!
What if we really
You took advantage
Have
An of all we could do
EHR. with EHRs?
Now
What? The Healing Edge: The Power of Combining Innovation + HIT / Lyle Berkowitz, MD / AMDIS 6.28.12

10. Chapter 3
You Inflection Navigator
Have Messaging and Chart Review
An • Physician notifies Care Coordination Team
EHR. about an ―Inflection Point Checklist‖
• Care Coordinator does authorizations, sets up
Now tests and consults, and does final chart reviews
What? The Healing Edge: The Power of Combining Innovation + HIT / Lyle Berkowitz, MD / AMDIS 6.28.12

11. Chapter 4
You Making ―Right‖ Easier
Have CDS Tools and Ordering
An • Allows whomever is with a patient to easily
EHR. see and act upon relevant ―care
opportunities‖ , while still respecting visit
Now workflows.
What? The Healing Edge: The Power of Combining Innovation + HIT / Lyle Berkowitz, MD / AMDIS 6.28.12

12. Chapter 5
You Prevention Every Time
Have CDS Tools, Ordering and Reporting
An • Pre-Visit Preventive Screening Tool
EHR. • An Instant Quality Measures Tool
Now • Real-Time Provider Performance Feedback Tool
What? The Healing Edge: The Power of Combining Innovation + HIT / Lyle Berkowitz, MD / AMDIS 6.28.12

13. Chapter 6
You Logic Rules
Have Conditional Logic, Ordering, Notes
An • Pre-Visit Orders: helps staff pre-order lab
tests before a patient's Annual Exam visit.
EHR. • Documentation Chooser: Helps MAs
Now choose the correct documentation templates at
What? an office visit.
The Healing Edge: The Power of Combining Innovation + HIT / Lyle Berkowitz, MD / AMDIS 6.28.12

14. Chapter 7
Team Bundling
You
Have Alerts, Registry, Pt Outreach, Reporting
• Team-based approach to care :
An Automating and Delegating tasks across team
• All or None Bundle Philosophy: Report
EHR. the % of pt who receive every element of
Now recommended care (rather than % that achieve
any particular measure).
What? The Healing Edge: The Power of Combining Innovation + HIT / Lyle Berkowitz, MD / AMDIS 6.28.12

15. Chapter 8
You Automatically Getting Better
Have Reporting Tools
An •Automated Adverse Event Detection:
Queries EMR for abnormal labs (e.g. low
EHR. glc, high INR) or meds (e.g. Naloxone, Vit K)
Now • Nurse-led Analysis: To determine level of
harm and whether it was preventable
What? The Healing Edge: The Power of Combining Innovation + HIT / Lyle Berkowitz, MD / AMDIS 6.28.12

16. Office Visits are so
old school! Time for
a ―whole lotta tele‖:
Televisit, Teleconsul
t, Telemonitoring
Meet
You and Teletranslation
At
01100101 The Healing Edge: The Power of Combining Innovation + HIT / Lyle Berkowitz, MD / AMDIS 6.28.12

17. Chapter 9
The Connected Patient
One of the First Patient Portals!
Meet It offers patients the ability to view their
medical information ("Health
You Record"), access relevant medical reference
At services ("Health Library"), and communicate
with their physicians ("Mail Center").
01100101 The Healing Edge: The Power of Combining Innovation + HIT / Lyle Berkowitz, MD / AMDIS 6.28.12

18. Chapter 10
The Virtual Consult
Consulting Specialists
Meet Asynchronous communication between
physicians, either between Primary Care and
You a Specialist, or between Specialists. Assigns
At RVU in theirValue based Reimbursement
Model.
01100101 The Healing Edge: The Power of Combining Innovation + HIT / Lyle Berkowitz, MD / AMDIS 6.28.12

19. Chapter 11
TeleVisits Keep IT Local
Virtual visit with an endocrinologist
Meet This virtual visit includes not only the remote
diabetes specialist and diabetes nurse, but
You also the locally based community clinic nurse
At and sometimes even the primary care
provider.
01100101 The Healing Edge: The Power of Combining Innovation + HIT / Lyle Berkowitz, MD / AMDIS 6.28.12

20. Chapter 12
Mommy Monitor
Home OB Monitoring
Meet A telehealth system which allows a high-risk
obstetrics (OB) clinic to monitor patients with
You high-risk conditions at home in between office
At visits. Includes a Glucometer, BP
Monitor, and Scale.
01100101 The Healing Edge: The Power of Combining Innovation + HIT / Lyle Berkowitz, MD / AMDIS 6.28.12

21. Chapter 13
Every Language Now
Tele-Translators
Meet Collaborative of hospitals and providers that share
the services of their trained language interpreters
You over a video and voice network Needed both
innovative uses of technology and an
At organizational and governance structure to
overcome the barriers that affect county-operated
01100101 health systems.
The Healing Edge: The Power of Combining Innovation + HIT / Lyle Berkowitz, MD / AMDIS 6.28.12

22. Chapter 14
Rise of the ePharmacists
Virtual Pharmacist
Meet An ePharmacist is defined as a hospital trained
pharmacist who works from a remote location using
You secured enabling technology to support bedside
clinicians with an effective and timely method of
At providing medication treatments for patients.
01100101 The Healing Edge: The Power of Combining Innovation + HIT / Lyle Berkowitz, MD / AMDIS 6.28.12

23. The future of
healthcare is
here, just look
On around! Happy
The Exploring!!! 
Edge
Of
The
Edge The Healing Edge: The Power of Combining Innovation + HIT / Lyle Berkowitz, MD / AMDIS 6.28.12

24. Chapter 15
On The Smartest Room
The A Computer/Monitor in Every Room
Edge • Detects who is in a given hospital room and
provides them with the information they need to
Of complete their job efficiently and reliably.
• Utilizes a real time locating system (RTLS) and
The a touch screen user interface designed to make
input/output quick and simple for end users.
Edge The Healing Edge: The Power of Combining Innovation + HIT / Lyle Berkowitz, MD / AMDIS 6.28.12

25. Chapter 16
On One EMR To Go Please
The Mobile EHR (mEHR) app
Edge • Enables providers to user their consumer
smart phones to securely access the
Of organization’s electronic medical record.
• Heavily leveraged existing enterprise
The architecture, providing for high levels of
security, availability, and agility.
Edge The Healing Edge: The Power of Combining Innovation + HIT / Lyle Berkowitz, MD / AMDIS 6.28.12

26. Chapter 17
On Real Time, Right Care
The Ventilator-Associated Pneumonia (VAP) Quality
Edge Monitor
• Compares real time EMR data against pre-defined
Of processes of care related to VAP.
The • Presents results on a dashboard tool via a wall-
mounted monitor (or on desktop PC).
Edge The Healing Edge: The Power of Combining Innovation + HIT / Lyle Berkowitz, MD / AMDIS 6.28.12

27. Chapter 18
On Dashboards 2.0
The Over 40 dashboards have been developed
Edge • Extract and analyze data from EMR and financial
Of
systems. Uses off-the-shelf business intelligence tools.
• The IT Dept isn’t the gatekeeper anymore—users are
The empowered to come up with creative ways to examine a
Edge
problem and develop equally creative solutions.
The Healing Edge: The Power of Combining Innovation + HIT / Lyle Berkowitz, MD / AMDIS 6.28.12

28. Chapter 20
On The Gaming Edge
The Gaming , IT and Health
• Improve motivation, and engagement via use of
Edge elements such as: Fun, Goals, and Rewards.
Of • Want to get into ―The Flow‖:
Skills, Feedback, Focus, LOC, Transformation of
The Time.
•Examples: From Twister to Wii to Nikeplus to
Edge SnowWorld to DrHero to FoldIt.
The Healing Edge: The Power of Combining Innovation + HIT / Lyle Berkowitz, MD / AMDIS 6.28.12

29. The New CIO
Chief Innovation Officer
Source: Innovation Leadership Study: Managing Innovation –
An Insider's Perspective. CapGemini Consulting. March, 2012
The Healing Edge: The Power of Combining Innovation + HIT / Lyle Berkowitz, MD / AMDIS 6.28.12

30. "The reasonable man adapts himself
to the world. The unreasonable one
persists in trying to adapt the world
to himself. Therefore, all progress
depends on the unreasonable man.‖
George Bernard Shaw
Never doubt that a small group of
thoughtful, committed people can
change the world. Indeed, it is the
Innovation only thing that ever has.
+ Margaret Mead
Information
Technology The Healing Edge: The Power of Combining Innovation + HIT / Lyle Berkowitz, MD / AMDIS 6.28.12

31. THANK
YOU
Lyle Berkowitz, MD, FACP, FHIMSS
Lyle@drlyle.com
The Healing Edge: The Power of Combining Innovation + HIT / Lyle Berkowitz, MD / AMDIS 6.28.12

32. Szollosi Healthcare
Innovation Program
(SHIP)
A charitable endeavor with a
mission to use creative thinking and
diverse technologies to produce a
better healthcare experience for
patients, physicians and others
associated with their care.
www.TheShipHome.org
The Healing Edge: The Power of Combining Innovation + HIT / Lyle Berkowitz, MD / AMDIS 6.28.12

33. Future of EMRs
Prototype examples which
rethink the look and feel of
user interfaces for
Electronic Medical Records.
www.TheShipHome.org
The Healing Edge: The Power of Combining Innovation + HIT / Lyle Berkowitz, MD / AMDIS 6.28.12

34. Inflection Navigator
An ambulatory-based triage
system and web-based tool
that supports a navigator
guiding patients thru an
acute healthcare inflection
point.
www.TheShipHome.org
The Healing Edge: The Power of Combining Innovation + HIT / Lyle Berkowitz, MD / AMDIS 6.28.12

35. ExpectED
A web-based application that
allows physicians to
electronically notify an
emergency department (ED)
about an incoming patient .
www.TheShipHome.org
The Healing Edge: The Power of Combining Innovation + HIT / Lyle Berkowitz, MD / AMDIS 6.28.12

36. Szollosi Healthcare Innovation Program (SHIP)
A charitable endeavor with a mission to use creative thinking and diverse
technologies to produce a better healthcare experience for
patients, physicians and others associated with their care.
www.TheSHIPHome.org
ExpectED - A web-based application that
allows physicians to electronically notify an
emergency department (ED) about an
incoming patient .
THE FUTURE of EMRs - Prototype
THE INFLECTION NAVIGATOR - An examples which rethink the look and feel of
ambulatory-based triage system and web-based user interfaces for Electronic Medical Records.
tool that supports a navigator guiding patients
thru an acute healthcare inflection point.
The Healing Edge: The Power of Combining Innovation + HIT / Lyle Berkowitz, MD / AMDIS 6.28.12