June 21, 2019

Ask doctors how they feel about electronic medical records (EMRs), and chances are a number will tell you they are time-consuming and cumbersome to use, especially when it comes to tapping their vast data for research.

As a physician and the director of non­invasive cardiac imaging at Johns Hop­kins Children’s Center, Philip Spevak is well aware of those challenges.

“We’re at a point where we have tons of data, yet sometimes we feel we still don’t know what’s going on or that we can’t find the information we want,” he says.

Now, as the first chief informatics of­ficer at the Children’s Center, Spevak hopes he can help ease some of the in­formation overload that so many physi­cians, patients and families experience. He has two goals: bring value to patients, and make the electronic record more beneficial and easier to use for provid­ers, patients and parents.

Spevak focuses on helping doctors make better treatment decisions with support from EMRs. For instance, he has launched a project for children with asthma—one of several illnesses targeted because it lacks a consistent treatment routine for doctors to follow.

“I’m particularly interested in areas where there’s a variability in care that might result in children staying in the hospital too long, or where we’re all paying too much for the cost of that care,” he explains.

Spevak is collaborating with a team of doctors, nurses, respiratory care thera­pists and pharmacists to develop a stan­dardized approach to asthma care, with help from data from Johns Hopkins’ Epic electronic health records system. He is also considering working with other care teams and Epic data to im­prove treatments for appendicitis, ba­bies born with opioid dependence and children with ketoacidosis, a potentially deadly complication of diabetes.

“The problems that I get to work on in this job, are things I get excited about,” says Spevak.

Tina Cheng, director of the Department of Pediatrics, says the new informatics position highlights how important it has become for hospitals to use data from EMRs and other sources to improve care.

“It’s a critical role not just for ensur­ing quality of care for children, but also for innovating health care delivery and enhancing research using big data,” says Cheng.

For Spevak, the new responsibilities have been gratifying. He recently helped address delays confirming patients’ weight in Epic. Nurses complained that these weight omissions hampered their ability to calculate medication doses promptly.

They were able to make some tweaks to Epic, and it is now much easier to ob­tain a patient’s weight.

“In one day, our compliance with entering weight went from roughly 40 percent to 80 percent,” says Spevak, noting the potential of informatics. “We helped a lot of kids with a few hours of programming.”