Richard Milani, MD, FACC, FAHA
Podcast

Richard Milani, MD: How Innovators Can Improve The Clinical Experience For Patients

January 19, 2018   EHR Innovation Podcast

We didn’t begin seeing the Clinical Transformation Officer role within healthcare in wide numbers until around 2014. Possibly this is due, in part, to the multi-disciplinary domain of digital health becoming widely viewed as providing an avenue for transforming healthcare at the same time. Today’s podcast with Ocshner’s Clinical Transformation Officer Dr. Richard Milani takes even those with limited knowledge of the role and provides context into how this role fits within the ecosystem of healthcare innovation. Datica’s Chief Data Officer, Mark Olschesky, sat down with Dr. Milani while in New Orleans to speak at the HL7 Partners in Interoperability Summit, and visited with him to learn more about the innovations that Ocshner is delivering—and how this health system views clinical transformation.

Dr. Milani responds:

On why health systems are adding Clinical Transformation Officers: “We realize and recognize that we have to transform ourselves in order to be more cost-effective and achieve better quality outcomes — not only the U.S. but across the world.

Their sole purpose is to be able to ready health systems for the needed transformation that is coming.”

On value-based care: “I think that it is the best thing that could happen for people, because at the end of the day you want to see a physician or go to a hospital that’s going to deliver high value, high quality, safe care, in the most efficient way possible for you so you can get what you need done, get out safely and not have problems that occur, or repeat hospitalizations for whatever procedure you might have had.”

Death and Dollars - Milani Book

On the largest constraints for delivery of new innovations: “The biggest constraints are always going to be culture. We have to appeal to what is best for our customers and in this case patients are our customers; that generally helps things along. But typically the greatest difficulty you will have is culture and moving culture around.

On how the Ocshner innovation team works with the IT department: “We are independent but we are close in terms of not interfering with the day-to-day job that they have to perform, which is to keep the trains running on time. They need to make sure that our EMR is up-to-date, operational, safe, effective, secure and those are critically important functions. We work side by side with them.”

On the vendor approach that doesn’t align with a health system: “What doesn’t work is if a vendor is just purely just trying to sell their product and they are not interested ultimately in making this frictionless.”

I see vendors and systems coming together much more collegially than in the past and clearly and has demonstrated the real significant impact of interoperability.

On the state of interoperability: “I see vendors and systems coming together much more collegially than in the past and clearly and has demonstrated the real significant impact of interoperability. Having the information in one location where we can now categorize and do all kinds of things with that information to interact with the patient at the right moment, at the right time, and at the right place is critical for us.”

On Ocshner’s transformation focus: “Our mantra has always been the quadruple aim. Anything that we do from an innovation perspective tries to target at least one, if not all the principles of the quadruple aim, which is namely improving the health of the population, improving the quality of the care that we provide, reducing the costs of care for our population and finally, the fourth aim is now — how can we do this while improving the workload on the providers of care.”

On ideas for clinicians and informaticists working at startups: “Clearly, for any startup in the healthcare sector, it’s going to be difficult for you to be able to sell whatever product you have, unless you have some real-world data and outcomes based on that data. I think it would be very important for any of these small startups to develop relationships with delivery systems to say: We’ve got this idea. Do you think this has legs? Not only to test it out, but to get advice and feedback. We provide counsel to a lot of small startups. Sometimes the way they imagine healthcare delivery to be is somewhat different than it really is.”

Today's Guest

Richard Milani, MD, FACC, FAHA
Richard Milani, MD, FACC, FAHA

Clinical Transformation Officer, Ocshner Health System

Dr. Richard Milani is the Chief Clinical Transformation Officer and Vice-Chairman of the Department of Cardiology at Ochsner Health System.

His background and research focuses on population health with a special interest in chronic disease and medical informatics. After receiving his Internal medicine training at the University of Florida, Dr. Milani completed fellowships in Critical Care Medicine at the University of Florida, Preventive Medicine and Clinical Epidemiology at Harvard University, and Cardiovascular Diseases at Ochsner Clinic Foundation. He has authored over 500 medical publications, including his upcoming book: Death and Dollars: Solving the Epidemic of Chronic Disease.

Our Interviewer

Mark Olschesky

Chief Data Officer

Mark joined Datica to help bring healthcare forward into the new era of value-based care. He believes in the value of openness and transparency, but the importance of privacy and security.