Edgar Y. Chou, MD, MS, Chief Value Officer and Chief Medical Informatics Officer; Associate Professor of Medicine, Division of Internal Medicine
WHAT ARE YOUR PRIMARY responsibilities as chief value officer?
We are now working in a value-based environment in health care. Under the Affordable Care Act, the federal government adopted a concept known as the Triple Aim of Medicine — to improve patient care quality, improve patient satisfaction and decrease costs. My responsibilities encompass those three areas. I also function as chief quality officer, looking at how to improve care primarily in the outpatient setting. In addition, continuing in the role of chief medical informatics officer, I am responsible for our electronic health record and the implementation of technologies with the goals of improving patient care, minimizing patient safety issues, and improving efficiencies.
WHAT ARE your goals?
A key goal is to leverage our wealth of health care data to improve the care of our patients. We need to incorporate the cost equation more in our day-to-day activities as part of regulatory agency requirements. We're working to implement greater clinical decision support within our system, to provide reminders for preventive screenings and for the management of chronic diseases, and to aid in treatment decisions. We've been collaborating with our colleagues in Drexel's College of Computing & Informatics to achieve this.
We are working with Drexel's School of Public Health to identify social determinants of health that impact patient populations, such as socioeconomic status, access to healthy food and transportation challenges. It's exciting to think that if we do find links between those factors and certain disease states, we could use that data to improve care.
The College of Medicine is one of four key participants in The Philly Difference: Connections for Better Chronic Care, a research initiative (funded by a grant from the CDC to the Philadelphia Department of Public Health) to improve population health in the city by focusing on improving care for chronic conditions, including diabetes, obesity and hypertension. We are able to query our system for patients with different disease states and can determine correlations with the different signs and symptoms associated with the development of these conditions. The goal is to develop predictive models with these risk factors to allow for earlier diagnoses or earlier interventions in the management of these diseases.
For another federal research effort, the Precision Medicine Initiative, we will incorporate gene testing to provide additional data to help physicians in decision making about patient care.
WHAT ARE THE BIGGEST challenges to meeting your goals?
Our biggest challenge is working with today's electronic health record systems. They have created many additional tasks for physicians and medical staff that are very time consuming. Last fall, a study showed that every one hour of activity a clinician had in the clinical setting resulted in two hours of documentation within that setting, plus two more hours of work at home. This has led to frustration and burnout. We are working to minimize these tasks while still fulfilling federal regulatory requirements. Following the Triple Aim concept mentioned earlier, the term Quadruple Aim was coined: The fourth aim is maintaining the health of the physician and their staff.
WHAT OTHER INITIATIVES are you working on?
I chair the College of Medicine's Quality Metric and Performance improvement committee, which provides quarterly updates regarding performance and progress with respect to our multiple regulatory programs and efforts on improving how the electronic health record (Allscripts) functions. I also provide monthly educational sessions for government-sponsored quality and value-based programs for the Drexel University Physicians Clinical Advisory Board, and as senior associate director of the Internal Medicine Residency program, I share this information with our residents. In addition, we have started a clinical informatics elective for our medical students.