Q&A: Wolters Kluwer Health's Saghbini on potential improvements in health IT

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 - Jean-Claude Saghbini

As Wolters Kluwer Health's newly appointed vice president and chief technology officer, Jean-Claude Saghbini, MS, promises to develop new technologies and system improvements. In an exclusive interview with Clinical Innovation & Technology, Saghbini talks about the future healthcare technology, areas of improvement and plans for Wolters Kluwer Health.

Clinical Innovation & Technology: Technology has become an integral part of the healthcare system, in your new role as Vice President and Chief technology officer what are your plans for healthcare technology?

Jean-Claude Saghbini, MS: The primary goal of health IT is to improve care outcomes, patient experience and efficiencies while reducing costs and improving the health of populations, essentially the Triple Aim. This can be addressed with solutions that reduce gaps in clinical knowledge at point of care, enabling both healthcare professionals and patients to make the right decisions and take the right action.

Part of our R&D focus is directed toward advancing clinical point of care insights and patient engagement, as well as medical learning and research. For example, we are exploring new solutions that leverage artificial intelligence (AI) and electronic health record (EHR) integration to optimize the user experience for clinical decision support. The most relevant information is served to the clinician, in the context of the specific symptoms and diagnosis of the patient they are treating. We are also looking at how people learn and retain information. For example, we are developing adaptive learning techniques that optimize the educational journey of the clinician. Beyond that, there are a number of other technologies that hold great promise in transforming healthcare. Blockchain is one example, which I expect will have a significant impact on our ability to access secure patient information wherever it’s needed.

What emerging technologies to you foresee playing a bigger part in healthcare?

Regarding AI, there remains a great deal of work to be done in each of these areas. We are just beginning to realize the full potential of AI in healthcare, and it has long way to go before it becomes ubiquitous. While we are discovering new ways to leverage its potential to improve care outcomes, more work must be done to integrate it seamlessly into clinical settings alongside human intelligence.

Along those same lines, wearables and patient-centric technologies are seeing a high adoption rate and generating vast amounts of data about the patient’s health. The next evolution in this space is to leverage this data, through a combination of machine learning and data interfaces, and integrate it into the care setting to provide meaningful and actionable information for both clinicians and patients.

I also mentioned blockchain earlier. Currently, a patient’s health data is scattered between a multitude of systems at the various institutions where they received care. Blockchain is a promising technology that could enable access to the patient’s health information regardless of the location of care. This comprehensive view of the patient’s health record will be key to accurate diagnosis, treatment and care planning.

The implementation of EHRs has changed the way patients and their physicians communicate, how do you think the relationship can be further improved?

One of the benefits of the EHR is that clinicians can hold a patient’s record in the palm of their hand and have access to past and present medical information to make informed care decisions. The downside is that clinicians must spend an inordinate amount of time keying that data into the EHR or trying to find it—time they could be interacting with their patients. We are working on technologies that integrate with the EHR to extract information about the patient’s condition and cross reference it with the Wolters Kluwer corpus of medical information. We will automatically serve patient-specific, evidence-based recommendations and alerts that minimize errors and clinical variability without attempting to replace clinical judgement. We want to optimize the clinician’s decision support experience and give time back to them, to interact with their patients. Only then will the full benefit of the EHR be realized.

Some patients may get the impression physicians can be distracted by EHRs. How can you get the public to accept their use in in-office visits?

There is no question that EHRs can sometimes be a distraction for physicians and patients. The presence of that computer or device often takes valuable time away from the physician-patient interaction. On the other hand, EHRs are here to stay and the data they are collecting is extremely important. We therefore need to find ways to give time back to the patient interaction, and the answer to that is also based on the EHR. As we start to leverage all the data that has been collected and combine it with Machine Learning techniques and clinical domain knowledge, we will be able to extract and serve up only what is relevant, leaving more time for the clinician and the patient to interact.

Do you believe a current healthcare technology or approach is being underutilized?

Integration. As an industry, we have been focusing on best-of-breed standalone technologies and solutions. We have not paid enough attention to integration technologies that allow data to be seamlessly exchanged. The HL7 standards have been a big help, and the Fast Healthcare Interoperability Resources (FHIR) standard by HL7 is gaining momentum, but much is still needed and we need to accelerate the adoption of these standards by healthcare IT organizations. Only then can we unlock the full potential of personalized care and clinical decision support to improve care outcomes.