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Keeping It Credible

May 20, 2010
by Mark Hagland
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Vivek Reddy, M.D., Medical Director of Hospital Information Technology, University of Pittsburgh Medical Center, answers questions about the challenges and opportunities to use clinical IT to improve patient safety, care quality, and clinical effectivenes

Vivek Reddy, M.D., is a key member of the multidisciplinary team of clinical informaticists helping to lead the charge into clinical transformation at the University of Pittsburgh Medical Center (UPMC) health system in Pittsburgh, Pa. Reddy, who joined the team of informaticists at the 20-hospital system three years ago, spoke recently with Editor-in-Chief Mark Hagland regarding the challenges and opportunities present within the UPMC organization to use clinical IT to improve patient safety, care quality, and clinician effectiveness. He and his colleagues will be featured in the upcoming July cover story on clinical informaticist teams.

Healthcare Informatics: How long have you been in your present position?

Vivek Reddy, M.D.: I’m finishing up my third year.

HCI: Do you retain any clinical practice?

Reddy: Yes, I’m still spend somewhere between 25 and 50 percent of my time on clinical practice. I call it a “50-90” split! I see patients about one day a week on the ambulatory side, and on the inpatient side, I’m on service a quarter of the year.

HCI: What is your medical specialty?

Reddy: Neurology.

HCI: What made you decide to go into clinical informatics?

Reddy: It wasn’t something that I’d been planning long-term. When I was starting my clinical training and my internship, I had a natural hobby around technology. The story on the street is that I complained about something, and Dan Martich [G. Daniel Martich, M.D., associate chief medical officer and CMIO at UPMC] recruited me for something. And after that, I got involved at sort of a high level, and then it just went forward from there. I’ve done other leadership roles in college and medical school, but I didn’t go into my residency training thinking this was the direction I’d go; instead, it just fell into place. But I love it. And per the balance, for me, doing some clinical work helps me retain perspective. But I couldn’t do all informatics all the time—I need some of that balance to know how things are working. And I derive personal satisfaction from practice.

HCI: What things does a successful physician informaticist need? More generally, what does any clinical informaticist need to be successful?

Reddy: Well, the first thing that any type of clinical informaticist needs is good communication skills. To be able to explain why technology is needed and how it’s needed is a vital component in the success of any team like ours. In addition, success means being partners to a lot of different people. And as a physician informaticist, it’s not just about partnering with physicians, but rather with the entire care team and the care process. And clinical informaticists who are successful look more holistically beyond their discipline or sub-discipline at the broader care process.

HCI: Is it necessary for physician informaticists to remain in practice to retain that credibility?

Reddy: I think it is initially. And you’re right, at a certain level, that changes. But being in clinical practice definitely gives you credibility. And I think it’s definitely helped me stay in touch.

HCI: Would you agree that you also need to have the ability to sit down with nurse and pharmacist informaticists and take the broader view?

Reddy: Yes, I agree. Individual operational silos can achieve their goals for a year or so fairly successfully without having to really speak to other groups. But when it comes to informatics, one of our strengths at UPMC is that we absolutely do not accept the model of not having everyone in the same room together. And there isn’t a conversation we have where we don’t say, what would Marianne [Marianne McConnell, R.N., UPMC’s executive director, clinical and operational informatics] say to that? Or, that wouldn’t work for pharmacy. So yes, your role as a pharmacist informaticist is absolutely to represent pharmacy, but also to contribute to the bigger puzzle.

HCI: What other things make things work at UPMC?

Reddy: I think that we’ve gotten very good at sort of identifying a problem, and when we see a problem, sort of getting into a room and quickly and efficiently getting to the root of problems and solving them. We’ve strayed away from being overly visionary, if you will, and instead, we’ve stayed in the trenches, focusing on being effective and getting to a solution quickly. And we run meetings very efficiently, determine the pros and cons and developing a solution and moving forward. Also, we do a significant amount of work in educating our peers and our leadership in how things work. And we have very strong executive buy-in, which is reinforced, because we don’t speak to the executives in a foreign language.

HCI: You’re a translator/interpreter between language groups, really?

Reddy: Yes, exactly. And we couldn’t have started at the level of detail we’re at, with the executives, at the beginning. We’ve gradually moved forward through that. But it gives us a sense of confidence that the executive leadership truly buys in, because they actually understand what we’re trying to accomplish.