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Podcast: CIO Dan Nigrin on Note Bloat, “Constant” Training & His Move to Maine

September 13, 2021

Winston Churchill famously said, “Never let a good crisis go to waste.”
In healthcare, that crisis, of course, is the Covid-19 pandemic, which has played a critical role in advancing digital tools — and changing the way care is delivered. “It has been eye-opening,” said Dan Nigrin, MD, who has served as CIO at MaineHealth since January.
The challenge going forward will be to ensure that the industry doesn’t lose momentum, which would certainly be a waste, noted Nigrin, who has more than 25 years’ experience as a pediatrician. Instead, he believes healthcare has an enormous opportunity to leverage the lessons learned during Covid-19 and create “a new standard of care.”
Recently, Nigrin spoke with healthsystemCIO about how his team is working to optimize and streamline processes to improve the experience for both patients and providers, and why physician satisfaction should be top of mind for all leaders. He also talked about transitioning from pediatrics – and city life in Boston – to a large system in Maine, and what his team is learning by participating in the Arch Collaborative.
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Key Takeaways

* One of the biggest workflow challenges facing many organizations is note bloat, which MaineHealth hopes to address by leveraging tools like voice and ambient listening.
* Most optimization issues stem from that the fact that organizations were focused solely on getting EHRs live, and not on getting maximum use of the technology.
* Vendors are continually working to improve functionality and provide new features, but without the right education and support in place, “it’s all for naught.”
* Although Nigrin admitted to having “some trepidation” about leaving Boston Children’s after 20-plus years to work for a larger organization, the opportunity was too “exciting” to pass up.
* Contrary to popular belief, the vast majority of care does not, in fact, occur in “large academic health centers located in big-city environments.”

Q&A with Daniel Nigrin, MD, Part 3 [Click to view Part 1 and Part 2]
Nigrin:  We’re also looking at new technologies. We’re doing some bleeding-edge things like Voice and Ambient Listening to see whether or not there’s a component of the documentation piece that we could take off of providers’ plates and allow them to either decrease — or, in an ideal world eliminate — that documentation burden that we all have after the visit is complete. That’s incredibly exciting new technology. It’s still evolving and being optimized, and we’ll have to see how quickly that can be perfected. But we want to be part of that perfecting process.
And so, like many organizations, we’re planning to pilot this work with small groups of providers over the course of the coming year. Our hope is that it’s successful and that we’ll be able to broaden it to more of our providers. Those are some of the ways in which we’re trying to tackle this.
Easing the documentation burden
There’s not going to be a silver bullet for this. Part of it is also the regulatory requirements around what documentation needs to be in the note; what components need to be in there. Again, part of it is education. I think our providers believe that the kitchen sink needs to be in their docu...