The 2023 recognition goes to David Reis, Ph.D., vice president of IT and chief information officer at UHealth, and his interdisciplinary team, for adding Epic electronic medical record system capabilities to the Game Changer vehicles operated by Sylvester Comprehensive Cancer Center.
“This is really evidence of our team approach in working with our physicians and researchers,” said Dr. Reis. “There are so many opportunities to leverage technology in new ways to help our patients where they are.”
The annual CIO 100 award recognizes initiatives that drive business growth through technology innovation. Sylvester, part of UHealth and the Miller School of Medicine, launched the first Game Changer in 2018, providing a vehicle to travel into communities to deliver cancer screenings and education. The focus is on prevention, diagnosis and treatment because certain cancers disproportionately affect some residents of these neighborhoods.
Connecting people in these underserved communities to the EMR system allows them to access the patient portal, engage more in their health care and communicate with their UHealth providers using their smartphones. “It’s really about education, cancer detection, prevention and referring them for treatment if needed,” said Lisa Swiontek, R.N., chief health application officer at UHealth.
For clinicians, the initiative means replacing paper forms with laptops to add information into the system more efficiently and in real time.
Another goal is to help people overcome any hesitancy in seeking medical care. “For some in this patient population, going into a physician office can create anxiety,” Swiontek said. “Even having them come to the mobile vehicle can sometimes be a challenge.”
The wireless setup was the easy part. Creating a different Epic service area was more challenging, but necessary. The strategy segregates the Sylvester Game Changer patients from the rest of the health system patients, storing their clinical data without billing them for services. There is also the bigger picture: If the same person comes into the emergency department in the future, providers can see their medical information in the EMR.
“We also know community care is already happening — but it may not be documented in Epic,” Swiontek said.
Dr. Reis added that the IT team had to tread carefully in adapting the technology. “We wanted to create this unique service area in Epic without negatively altering the Epic system used throughout other UHealth hospitals and clinics.”
Swiontek and Dr. Reis credit Erin Kobetz, Ph.D., M.P.H., vice provost for research at the University of Miami and associate director of population science and cancer disparities at Sylvester, with being the catalyst for the initiative. Dr. Kobetz was the first to suggest adding Epic to the Game Changer vehicles.
“Bringing Epic to the Game Changer vehicles bridges critical gaps in access to health information and technology, essential for advancing health equity,” said Dr. Kobetz. “It was a privilege to work with the UHealth IT team on this initiative, which is so connected to our institutional commitment to translational research that has measurable, community-facing impact.”
Deploying the Epic EMT System
Adding the EMR to the fleet of now three Game Changer vehicles is the first time Epic has been deployed outside a traditional clinical setting. The Sylvester Game Changer vehicles are retrofitted, air-conditioned motor homes equipped with private rooms for consultation and cancer screening and a multimedia area for cancer education.
The Sylvester Game Changer is also among the first in the United States to offer mobile prostate-specific antigen (PSA) screening for prostate cancer. Black men are at especially high risk for prostate cancer, which makes PSA testing in communities like Miami’s Little Haiti even more essential. Testing is free, and men who require further medical care are referred to other locations. And it’s not just men who stand to benefit. Women in Little Haiti have a much higher than average incidence of cervical cancer, and Sylvester investigators have created novel prevention strategies to overcome traditional barriers to screening, prevention and treatment.
This project will be used as a model for other areas. For example, Bascom Palmer Eye Institute is using the Epic-equipped Game Changer vehicles to provide free yearly eye screenings to school age children in some communities.
The UHealth IT team won the CIO 100 Award last year for technological advances in remote patient monitoring. The 2021 award was for automating the COVID-19 vaccination process to ensure that the inoculations could be administered swiftly and safely.
Asked what she is proudest of, Swiontek said, “It was that the team acted pretty quickly. We saw the need, and the team really pulled together with our operational counterparts to develop and deploy the Game Changer solution as quickly as we could.”
For Swiontek, winning the CIO 100 a third year in a row is “pretty spectacular.”