Adapting technology to enhance Michigan Medicine’s mission: Q&A with Ranjit Aiyagari, M.D.

September 26, 2017  //  FOUND IN: Strategy & Leadership,

Last month, Ranjit Aiyagari, M.D. was announced as chief medical information officer for Michigan Medicine.

Aiyagari oversees the Office of Clinical Informatics (OCI) and works closely with the organization’s chief information and chief clinical officers to bridge the gap between provider-facing technology systems and the strategic goals of the clinical enterprise.

He recently sat down with Headlines to discuss his role and how it differs from — and complements — other IT roles across the health system.

Q: Your title, chief medical information officer, is similar to another leader — Andrew Rosenberg, M.D., chief information officer. How are the two roles different?

RA: This is a frequent question, not only across Michigan Medicine, but across academic medical centers in general. The CIO is responsible for managing strategy-guided technology investments and all aspects of pure information technology — including storage, servers, network, security, hardware, applications, high performance and high availability, to name a few.

The CMIO is a doctor on the medical staff with deep knowledge of clinical informatics and change management. He or she provides guidance on adapting IT for clinical purposes, often brokering consensus within a large, diverse medical staff. My goal is to make sure our computer systems help providers as much as possible while they are tasked with delivering safe, quality care, educating students and trainees, and conducting research.

Q: You mention that the CMIO role in academic medical centers is filled by an M.D. Our CIO, Andrew Rosenberg, is also an M.D. Is this typical?

RA: It’s rather unusual for a CIO to be an M.D. In my opinion, Michigan Medicine is very fortunate to have a physician serve as its CIO. Andrew and I collaborate on many items, including health information exchange, data analytics and technology planning for new facilities.

In addition to my CMIO duties, I’m a pediatric cardiologist and continue to attend in the pediatric cardiothoracic unit. During my 12 years with Michigan Medicine, I’ve also attended in ambulatory, inpatient, procedural and consult settings.

Q: What value do you personally think the CMIO adds to a medical organization?

RA: I’m in some ways a translator between the clinical and IT worlds, which can be a confusing landscape. We have a number of redundant applications, systems with some health-related functionality but without seamless interconnectedness to our enterprise’s electronic health record (EHR), passwords and logins, and billing and documentation requirements.

Taken together, all of these have the potential to leave too little time and mental energy to focus on our actual missions of patient care, education and research. My OCI team works hard to clear some of this confusion and leave our providers free to concentrate on their patients and research.

But beyond this, the CMIO and the OCI play a key role in bringing forward innovative new technologies that enable new models of care, such as telehealth and virtual care. We have to leverage these types of models going forward to reach the goals set by David Spahlinger, M.D., to care for 4 million people throughout Michigan and provide comprehensive care to 400,000 patients locally while improving the value of the care we provide.

Q: That sounds like a huge undertaking. How does the OCI and your team help support this goal?

RA: The OCI works closely with the Office of Clinical Affairs (OCA) and Chief Medical Officer Jeffrey Desmond, M.D., to ensure that our work dovetails with the safety and quality goals of OCA, the office of the CMO, and that our work supports the strategic goals of the clinical enterprise.

We have 11 associate chief medical information officers (ACMIOs) representing key areas across our health system. We’re still in the process of communicating this structure and these individuals, but ideally faculty and staff in each area will work closely with their designated ACMIO. This will hopefully help optimize clinical workflow, saving time and headaches by giving each area a resource through which they can request significant EHR changes, share thoughts about other new/different systems, and voice ideas for better care, education and research through technology.

Q: What are some of the challenges and goals for you, the ACMIOs, and the OCI over the next year?

RA: Within our organization, we have a glut of very bright people with excellent ideas. As such, there are limits to what we can do — our work capacity is finite and we need to focus on changes that align with our organization’s strategy. Additionally, we have a vendor work with a vendor for our EHR system, meaning there are limitations in what we can and can’t change and control. We also operate within a capital budget and we constantly need to consider changes in the context of our cybersecurity risk tolerance.

Our major strategic initiatives for 2017-18 will be continuing to improve the usability of MiChart for providers and other clinicians; enhancing safety and quality through the EHR and related systems; maintaining full regulatory compliance; and increasing patient engagement (including eVisits, telehealth, patient-reported outcomes, e-Check in, and the patient portal).

We’ll also work toward making data available easily and promptly to those who need it while working closely alongside HITS to keep our health information safe from attack. Finally, we will work toward developing and deploying tools to educate learners in the safe and effective use of health information technologies.

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