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Featured topic and speakers
Associate Chief Medical Informatics Officer Josh Lesko, MD, joins us to discuss the need for physicians to have a voice in the development of the technology they use. Dr. Lesko talks about the benefit of having a degree in computer science as a physician, how practices can involve clinicians in technology development and lessons learned from the rollout of the EHR. AMA Chief Experience Officer Todd Unger hosts.
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Speaker
- Josh Lesko, MD, associate chief medical informatics officer, Naval Medical Center Portsmouth
Transcript
Dr. Lesko: This needs to change. This is actually delaying patient care or causing more administrative backlog and slowing the system down.
Unger: Hello and welcome to the AMA Update video and podcast. Today, we're talking about why physicians need a voice in technology development and what that can look like in practice. Our guest today is Dr. Josh Lesko, associate chief medical informatics officer at the Naval Medical Center Portsmouth in Portsmouth, Virginia. I'm Todd Unger, AMA's chief experience officer in Chicago. Dr. Lesko, welcome.
Dr. Lesko: Thanks, Todd. It's always a pleasure to be part of this.
Unger: One of the pleasures of working at the AMA for almost eight years is I got to know you as a medical student. And so, what an honor to be able to talk to you in your new capacity. And I think just for starters, it might be interesting for folks out there to hear a little bit about your career. It's been pretty interesting. You've kind of been at that intersection of medicine and technology. Tell us more about your background and what that looks like.
Dr. Lesko: Absolutely. And it honestly was not something that was planned. Undergrad, I knew I'd wanted to go to med school but didn't necessarily like being a bio/chem major and everything that came with that. So I found computer science and thought it was a really interesting and different approach to logical thinking.
So followed through with that, then went to med school and while there, kept finding projects where I could use my programming background or the algorithmic education that I had to improve efficiencies and make things better. And that continued on through my residency. And now as a staff where there's so many things that can be improved, this is just another tool in the tool kit to make improvements. And it's something that having that background, I can speak the language from the technology side and it really helps me be a part of these new innovative solutions.
Unger: Well, it's interesting. I'm sure it does help to have a computer science degree in that regard. But at this point, everybody needs to have a say in the technology they're using. For physicians, why is that so important, Dr. Lesko?
Dr. Lesko: Technology is not going away. And it is something that is becoming more and more integrated in every aspect of our lives and health care is no exception. With electronic health records, they primarily came out as billing tools and they were not made for workflows and efficiencies in mind.
So when physicians and the other end users are forced to use this day after day, it's not the most seamless experience. Moving forward, we need to be a part of every step of the process. So the consideration for what does the clinical impact of this mean and how will this affect our day-to-day is actually considered.
Unger: Well, that makes a lot of sense. I'm curious, give us a little background on how physicians have a voice in technology development at your own organization.
Dr. Lesko: Absolutely. So we have a steering committee that addresses all complaints of inefficiencies or changes that need to be made with our electronic health record. Or any time we're investigating a new system, we have piloted a few different AI programs to see how they can integrate.
And that's something that we're seeing pretty much at every major institution is what new tools are out there and how can we incorporate them into the work we do every day to ease those administrative burdens and lower the technological thresholds to get the job done.
Unger: Is that team kind of developing a roadmap as well, in addition to being the receivers of all the feedback?
Dr. Lesko: We are investigating a couple of different routes moving forward. It's at this point more of what are we seeing in the future and is that something that we can integrate to our organization or is that something that needs to be thought at a different point in time and responding to the needs of our specific hospital.
Unger: What's an example of a positive impact that approach has taken?
Dr. Lesko: One example of this positive approach is, again, having the physician voice heard. And when there are complaints of ways the system isn't working the way it should be intended, or if it's creating more roadblocks, having our clinical experience to be able to voice that and say this needs to change, this is actually delaying patient care or causing more administrative backlog and slowing the system down.
Unger: That makes a lot of sense. Well, this would not be a technology discussion unless we use the term AI. So let's turn our attention there. Practices are starting to use AI in your opinion, how can they avoid making some of the same mistakes that happened with the rollout of the EHR?
Dr. Lesko: The biggest way to not get behind the curve on AI is to be a part of the integration and discussion of it. With EHRs, it was very much again, billing tool and not a productivity and clinical focus tool.
If we want an AI products integrated into our workflows, we need our physicians to be a part of the conversations wherever it's being integrated, developed and rolled out to make sure that the voice of the customer, as the physicians, for lack of a better word, and those of the patients are heard.
Unger: Well, that makes a great deal of sense to make sure what the customers actually need. On the other end of that technology, your experience, your background in technology, it's been so valuable. How do we ensure that the next generation of physicians is educated in this arena.
Dr. Lesko: Education of AI is something that is rapidly expanding and evolving. There are many organizations tied into the medical community who are integrating educational sessions often asynchronously. For this purpose, ACGME has a course on integrating AI in medical education, AMA has modules as part of the STEPS Forward™ program.
So it's really as simple as looking a Google search to see what AI and health care is out there. Sometimes this is through your specialty organization because there are different workflows and opportunities for AI depending on what you do in your day to day.
Unger: Absolutely. And be sure to track what we're doing here on the AMA website. As Dr. Lesko mentioned, lots of resources here at AMA as we expand our knowledge about AI in medical practice.
Dr. Lesko, thank you so much for joining us and sharing your perspective on an issue that obviously impacts so many physicians. Making technology work for physicians is a key priority of the AMA. To support that work, become an AMA member at ama-assn.org/join.
That wraps up today's episode and we'll be back soon with another AMA Update. Be sure to subscribe for new episodes and find all our videos and podcasts at ama-assn.org/podcasts. Thanks for joining us today. Please take care.
Disclaimer: The viewpoints expressed in this podcast are those of the participants and/or do not necessarily reflect the views and policies of the AMA.
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