Healthcare Innovation Awards Q&A : Making Electronic Health Records Run More Efficiently

A Conversation with Thomas Charlton, President and CEO, Goliath Technologies

My career started with a healthcare company called U.S. Surgical; we provided health systems with stapling instruments for the operating room. So my familiarity with healthcare started from within the hospital. When I started Goliath Technologies, I was surprised to see that health systems were acquiring technology at such a rapid pace, but at a time when they were digitizing their medical records; and the HITECH Act provided different incentives for health systems to adopt electronic medical records; so I was reintroduced to healthcare via information technology.

How have you seen health IT change over the years, from your perspective?

It’s really unbelievable; when you think about an organization like a health system providing care for, in some cases, hundreds of thousands of people, moving from a paper-based system to an electronic medical records system. You have tens of thousands of caregivers who had been working with pen and paper, and now they’re using laptops and desktops, and so on. The change has been unbelievable, as all that change has fallen on the backs of health IT to make it happen. Caregivers have to learn how to use the systems, but IT has to make them run and working, no small feat.

So what are some of the opportunities available in healthcare?

The opportunities really are endless; centralized data analytics have the capability to help us provide much better quality of care. Look at something like leveraging predictive analytics, and how they can be used to analyze populations of hundreds of thousands of patients in order to predict the likelihood of heart attack or stroke, for example. Clinical trials are pretty interesting as well; if you think about how difficult a clinical trial is. It can take as long as 17 years to complete a clinical trial, and part of the reason is that only about 3 percent of the people who are invited to a clinical trial actually participate. So now, you can do clinical trials, or that level of assessment, using data across hundreds of thousands of different patients across geographies, etc. So the ability to abstract the information you need to approve a therapy or drug, can augment things like clinical trials, with good, solid data that’s gathered by the various EMR/EHR applications.

It sounds as though we’re talking about a new paradigm of care, one in which the role of HIT leaders is elevated.

When you think about it, IT is the foundational element. Yes, you have to customize the EMR/EHR, to support healthcare workflows and business processes, absolutely; but the application has to be available, it has to be reliable, and it has to perform. And that really comes down to IT’s focus on those foundational elements. If not, the application will be too difficult to use, and organizations will revert back to paper.

Explain a little bit about Goliath’s role in that process, in monitoring the efficiency of EHRs?

Let’s say you’re a large health system, running one of the major EHRs, whether Cerner, Epic, or Meditech, for example. And clinicians are there 24/7. One example of a feature of our technology is that, 24/7/365, automatically and intelligently, we’ll log in, making sure the EMR/EHR is up and available, for the eventuality of a clinician needing to access that application. If it’s not available, our technology will intelligently alert that IT organization so that they can proactively fix the problem.

You mentioned Meditech; they’re in place in a lot of smaller hospital organizations, for example. Is there a big difference in working with smaller, versus larger, hospital organizations?

No, and Epic and Cerner both offer versions of their technology that can be adopted by surgical centers and smaller health systems. But our technology was built for healthcare. There is a health IT challenge: if you look at supporting 20,000 users, an enterprise will have twice as any people and twice the budget as a health system will, to support the same number of users. So we built our technology with a tremendous amount of embedded intelligence and automation. What’s commonly said about our technology is that it is a purchase of software, but that it’s like adding two or three employees to your IT staff that are dedicated to monitoring and troubleshooting, so that IT can get ahead of end-user experience issues that impact patient care.

Have you seen a change in leaders who aren’t CIOs, getting involved now with EHRs now, like a CMIO, for instance?

Certainly, we deal with CIOs, and on down the org chart in IT, they’re our primary buyer and user; but very often, we’re seeing the CMIO involved in these conversations, because if the physicians are having trouble with the application, a lot of those conversations with flow up through CMIO. So it’s very common for CMIOs to be a part of the conversation. And a whole body of work has been centered around how we make EMRs/EHRs more usable by physicians and other clinicians. There’s a lot of change and innovation over the next ten years that will come, in terms of looking in new ways at how to use EMRs/EHRs—around making the applications more focused around patient outcomes and patient care, rather than merely capturing data.