Dr. Rob Lloyd is the Chief Medical Information Officer (CMIO) for Hamilton Health Sciences’ (HHS) Health Information Technology Service (HITS). Rob has been with HHS for 19 years in several roles including as an intensivist in the pediatric critical care unit at McMaster Children’s Hospital. He then served as medical director and division head for this unit before joining HITS.
What do you do?
I represent our clinicians’ needs to our informatics and IT staff, who build and customize our systems. To help with rollout of IT programs and services, I need to engage and educate clinicians as well. I think of myself as a translator between clinicians and IT because they each speak different languages. For instance, in IT, the word ‘business’ refers to the work the IT system supports, namely, the bedside care clinicians provide. But to a clinician, ‘business’ refers to non-clinical things that support bedside care, like IT.
In addition, I provide physician leadership and oversight to the eHealth office, which administers new technology initiatives such as ClinicalConnect. And, to ensure the sustainability of our sites, I advise hospital leadership on our growing computer and electronic needs.
“Motivation in this role is a lot different than motivation at the bedside.”
What keeps you motivated at work?
Motivation in this role is a lot different than motivation at the bedside. With direct patient care, you get immediate payoff, every day. The patient is right there in front of you, responding to your care and it’s immediately gratifying.
This role, however, is very much about delayed gratification. The rewards are far reaching and broad in scope, but they take a much longer time and require a lot more work to realize. And sometimes, they don’t. But the prospect of making a difference on such a large scale, and setting the stage for improvements that will continue to evolve for years to come, that’s very exciting to me. It’s the reason I do the job.
What made you enter your field of work?
As an intensivist, I was surrounded by numbers and data from so many different sources. Most of the job is about continually assessing multiple factors at the same time. I always liken it to the green digital rain in “The Matrix” with all the numbers cascading down the screen.
I got interested in the computer’s ability to combine all of this and analyze it for us, starting with an electronic flow sheet. This morphed into a more general interest in electronic workflow and how these systems can take on some of the more mundane work for us. Ultimately, that will help prevent us from making mistakes and improve the quality of care we deliver.
I realized we are just at the beginning of a revolution and I wanted to be part of it. I also enjoy listening, communicating and building consensus among colleagues, which is a large part of the job.
“I got interested in the computer’s ability to combine all of this and analyze it for us.”
Tell us about your most gratifying experience at HHS.
I have lots of powerful memories from the PICU, but in this CMIO role, I would have to say it’s been order sets. Order sets are related orders, such as tests and treatments, which a doctor can place with a few keystrokes or mouse clicks. Combining these into a set allows users to issue prepackaged groups of orders that apply to a certain diagnosis or a particular period of time. It saves time and standardizes care. In terms of bringing evidence and best practice to the bedside, I think this is the most impactful things we’ve ever done on a broad scale. It’s knowledge translation in action.
We’ve achieved a lot of consensus and standardization of care. The sets became a powerful tool for quality improvement at HHS. We currently have over 520 sets, with continuous upgrades and improvement happening every day. I’m quite proud of this work.
It will be even more exciting when we can start using them in a computerized provider order entry system, a way for medical instructions to be entered electronically. We can then take advantage of electronic checking and cross-referencing with our integrated decision support team to prevent us from making errors.