3 critical insights for EHR customization efforts: MidMichigan Health chief innovation officer

Pankaj Jandwani, MD, regional vice president of medical affairs and chief innovation officer at MidMichigan Health, joined the Midland, Mich.-based health system more than 17 years ago.

Dr. Jandwani is board certified in both clinical informatics and internal medicine, and he specializes in geriatric medicine. He is a member of the American College of Physicians, American Academy of Physical Medicine and Rehabilitation and American Geriatric Society. 

As CIO, Dr. Jandwani has overseen MidMichigan Health’s efforts since 2017 to transition various subsidiaries of the health system to its Epic EHR. Here, he discusses how MidMichigan Health has approached EHR customizations as well as current initiatives it is rolling out.

Editor’s Note: Responses have been lightly edited for clarity and length.

Question: What is one recent initiative you’ve taken to customize your EHR system?

Dr. Pankaj Jandwani: Since 2017, MidMichigan Health has been on a journey to convert a number of EHRs across our subsidiaries to Epic. While our guiding principle is to adopt the Epic’s foundation system, we design for safe and efficient clinical workflows specifically attending to resource availability at each of our locations across MidMichigan. To that end, we ensure our clinicians adopt the features available to them in Epic to personalize for their preferences. In addition, our governing committees oversee the standardization of key elements, such as order sets and alerts. We have also begun implementing predictive alerts for sepsis and risk for re-hospitalization, etc.

Q: What advice do you have for other hospitals looking to implement an EHR customization?

PJ: It is important to first define the term customization and tie it to the purpose and goals of the organization and its service areas. Guiding principles should be established for each organization considering the strengths and opportunities of tools and teams where such customization is considered.

Just as important, it is critical to ensure EHR customization efforts are focused on clinical optimization efforts: people, — always starting with patients — process and technology. Not the other way around.

Q: How do you promote innovation among your team members?

PJ: I’m very fortunate to work with passionate physicians, clinicians and leaders who are respectful of the voices of our patients and frontline teams. Our clinical design and optimization teams spend a lot of time in Gemba [a term for ‘the actual place’], mapping current state and collecting data to support insights and conclusions. We try to conduct small pilots of the iterative process and tool improvements. Our governing committees evaluate successful pilots for organizationwide implementation. What’s more, we leverage our collaborations with other health systems and Epic during this process.

Q: What has been one of your most memorable moments?

PJ: When the wife of one of our elderly patients, who was brought to MidMichigan after exhibiting symptoms of a stroke, said she was so glad her husband was brought to our critical access hospital emergency department. I still remember the gratitude expressed by this couple during the winter of 2016 as I was helping pilot tele-stroke and tele-neurology in two of our rural hospitals. He received excellent care from stroke and neurology specialists via the University of Michigan in Ann Arbor via telemedicine, while we avoided hundreds of miles of travel for them during the Michigan winter. I am very proud of our team expanding the use of our technology in many areas to add even more access and convenience for our patients.

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