One-on-One with UCSF Medical Center CMIO Michael Blum, M.D.

KG: Is the bar-coding system isolated to the perioperative department or are there interfaces in place — or at least plans to interface with supply chain or other departments?

MB: I’m not sure if there’s any intention to interface the sponge tracking to inventory systems.

I think that as we start looking at these tracking technologies in general, they will absolutely be integrated. This is one small example of tracking technologies, whether we use RFID to track where the patients are in our facility, or where our IV pumps are and so on, or whether we’re talking about bar coding of specimens. We bar code the blood draws and bar code the patient, and then we bar code the vile that the blood goes into to make sure it’s all matched up. Then that gets bar coded and scanned once it gets down into the lab, so that automates the integration into lab. So there’s already of a lot integration of bar coding and eventually RFID in other systems in the organization.

KG: Where is the blood vile bar coding live right now?

MB: It’s on the floors and in the laboratory, and we’re expanding that as we implement our new medical record to really even facilitate workflow and the matching of patients and specimens and easing the burden down in the laboratory. So that will get expanded even further.

KG: What is the new medical record you’re using, and what’s the status?

MB: We’re in the middle of implementing. We use GE Centricity Enterprise EMR and we’ve got most of it in place. Over the next year, we’re rolling out provider order entry, a new pharmacy system and clinical decision support. As part of doing that, we’re going to expand some of the other technologies at the same time. We use CareFusion’s specimen collection and bar code management in that space, and we’ll be rolling that out along with some additional patient tracking functionality.

KG: Where are you with RFID right now? Where is it live?

MB: We have RFID already in place for a lot equipment tracking, and a lot of that in the OR is already in place. We track over 1,000 devices, and that’s getting rolled out into much of the medical center.

KG: Of all the tracking you’re doing, sponge tracking seems like it is definitely the most cutting-edge technology being used.

MB: Foreign body left behind is a very high-profile issue and this is a very discreet application of the technology. But positive identification and tracking issue is a much broader issue that has not only safety implications but also operations implications, cost savings and efficiency in addition to the very high profile and highly important quality implications.

It comes back to the fact that we have to deploy the technology to do things that people don’t do particularly well, or that the top technology can do much more efficiently. These are perfect things for technology.

KG: So it’s fair to say that UCSF doesn’t shy away from cutting-edge technologies?

MB: Right. Gartner has a break-down; there are the early adopters, there are the mainstream people, and there the laggers in technology adoption. And we’re not on the bleeding edge of early adopters; we definitely wait to make sure others have validated that this stuff really works. But we’re pretty early; we’ve got an evolving history of being early adopters. We did the joint development with Motion Computing and Intel around the C5 clinician platform that was first launched here. And we’re the development partner with GE on Centricity EMR and we’re developing their first generation integrated ICU information system. So we pretty aggressively adopt technology, but we still avoid being on the bleeding edge of it.

KG: That seems like a pretty sound approach. But as CMIO, does that tendency to adopt on the early side and partner with vendors make the job more challenging?

MB: It certainly makes my job more interesting. I’m almost schizophrenic about it. One day I’m pushing to adopt a technology that’s pretty early on and not completely proven, and the next day, when someone wants to bring in another technology, I’ll say, ‘it’s too early, it’s not proven enough yet’.

I have a pretty strong technology background and obviously I’m a clinician, so one of my jobs is to assess which of these technologies is really appropriate. And I’m in the position to have one of the better perspectives on, is this really going to bring us benefit for the patient’s perspectives? Or is this something that just seems cool that’s going to kind of be a flash in the pan and then go away. That’s one of the challenges.

KG: We hear a lot about that – with so many technologies coming out all the time, it seems like one of the biggest challenges is deciding which ones have staying power. I imagine that can’t be an easy task, with all the technologies that come across your plate.