3/2013-present Vice President, Clinical Information (Inpatient Chief Medical Information Officer), Advocate Health Care, Downers Grove, Illinois
Optimize the clinical information systems supporting the inpatient independent ordering provider community including chart review, order entry, documentation, decision support and transitions of care.
- Optimizing the inpatient electronic medical record (Cerner) for independent ordering providers
- Serve as the principal point of contact for over 5000 owned and affiliated providers across eight different hospitals with questions about existing functionality and suggestions to improve the software
- Develop workflows for teaching and community hospitals on the same electronic medical record platform including leveraging the organization’s internal health information exchange to share information across care settings
- Chair the corporate clinical information systems steering committee to determine the roadmap of changes to the software for the next six-12 months
- Chair the medical directors of clinical informatics committee to share information and obtain input from site informatics leadership
- Reduced transcription costs by 30% in 2015 (approximately $4 million) by
- Obtaining senior leadership support to drive physician behavior toward voice-to-text technologies including desktop speech recognition and Cerner’s mobile app use
- Influencing site clinical informatics teams and hospital physician leadership councils to encourage providers to use voice-to-text and other technologies
- Developed site-specific performance scorecards with physician-level detail to identify candidates who might benefit from using voice-to-text technologies
- Developed regular cycle of delivering educational materials for physician community including
- Training videos with closed captions for desktop and mobile platforms
- One-page pdf documents with additional information within hyperlinks to limit how much information all users need to review
- On-line reference for documentation tips (clinical documentation improvement and ICD-10), ordering workflows, and new electronic medical record technology that includes an avenue for the end-users to provide real-time feedback on the quality of the information (advocatephysicianinformatics.com)
- Developed decision support to help physicians and nurses meet publicly-reported metrics for sepsis detection and early treatment that
- Allowed role-specific alerts to tailor diagnostic and treatment recommendations based on clinical consensus and each user’s scope of practice
- Included a lactate reflex order to support tracking blood level changes over time without any keystrokes from an end-user
- Instituted National Provider Identifier within the electronic medical record as key to consolidate eight hospital-specific provider directories into a single provider directory to serve all eight sites
- Engaged medical staff offices, information technology, access, security and clinical informatics to identify current state, intermediate future state and end-state with roles and responsbilities for each stage
- Validated testing plan with Information Technology to verify no downstream clinical systems would be adversely affected by the changes
- Developed training documents for relevant stakeholders
- Targeted computerized physician order entry (CPOE) improvement tactics based on
- Creating actionable reports at the physician level using R to process over a million orders a month
- Engaging hospital leadership to drive improvements in hospitalist CPOE rates
- Developing workflows for nurses to update orders without generating new phone or verbal orders for physicians to co-sign
- Developing protocols and order sets to manage common clinical conditions
12/2007-3/2013 Associate Medical Director, University of California, San Diego Medical Center
San Diego Beacon Collaborative (Co-Principal Investigator)
$15.3 million collaborative agreement from the Office of the National Coordinator of Health Information Technology to test approaches to improve health care across a metropolitan area using health information technology
- Translated the clinical community’s expectations into a series of customized applications:
- Gathered stakeholder information,
- Helped draft request for proposals,
- Negotiated the contracts with the vendor and the University of California, San Diego’s legal team including defining specific acceptance criteria for payment
- Worked with project programmers and technology vendors to develop working prototypes, and
- Validated the application with prospective end-users
Major contributor for two of the software deployments
- Health information exchange to interface with electronic medical records across the San Diego metropolitan area including federal health systems, private integrated delivery systems and stand-alone electronic medical record systems
- DIRECT (secure email) to share patient health information with providers and health plans when a patient has registered to be seen in an emergency room, admitted to an inpatient facility or discharged from an inpatient facility
- Developed the Collaborative’s privacy and security practices through deliberations with local site privacy officers with a vision that a patient’s demographic information would be the only data shared among competitors within the metropolitan area, but clinicians could query sites for patient-specific data on-demand
- Drafted the project’s business plan to move the project from a federally funded project to an independent entity supported by multiple medical centers, health care providers and payors
- Directed the activities of two project managers and two programmers to accommodate the project’s evolution
Ambulatory Electronic Medical Record (Epic) optimization
Led initiatives for the outpatient provider communities working with programmers, database analysts, medical center leadership and providers to achieve quality goals and safety initiatives using the electronic medical record
- Physician lead for hospital and 222 providers to qualify for Stage 1 Meaningful Use in 2011 (approximately $10 million)
- Leveraged the electronic medical record’s decision support technology to improve the medical group’s pay-for-performance quality scores to achieve statewide recognition for excellent performance each year for the past three years
- Helped analytics team refine feedback reports to providers including metrics for ordered tests, resulted tests and tests within control
- Developed nurse and provider task reminders within the context of an office visit for appropriate test ordering resulting in a 20% increase in appropriate test ordering for diabetes monitoring, breast cancer screening and immunizations
- Formulated a strategy to have nurses reach out to patients between office visits for appropriate testing using the electronic medical record
- Implemented medical center response to two drug recalls including patient outreach by letter, reminders to ordering providers to remove the drugs from active medication lists and preventing providers from re-ordering the medications
- Physician lead for patient portal cited by patients as one of the primary reasons they continue to receive care at the University of California San Diego Health System
7/2003-12/2007 Assistant Professor of Medicine, Wayne State University, Detroit, MI
- Wrote grants and manuscripts
- Delivered clinical care to patients in the inpatient and outpatient settings
Education and Certifications
12/2013 Certified by the American Board of Preventive Medicine in Clinical Informatics
12/2011 Masters of Business Administration, San Diego State University
8/2011 Re-certified by the American Board of Internal Medicine (#206472)
7/2001-6/2003 General Medicine Fellow in Outcomes Research, University of Vermont
7/1998-6/2001 Internal Medicine Primary Care Residency, Barnes-Jewish Hospital, Washington University
7/1994-5/1998 Doctor of Medicine, Emory University
Bronner JP, Fontanesi J, Goel A. Improving prompt effectiveness in diabetes care: an intervention study. American Journal of Medical Quality 2012;27(5):406-10.
Kim H, El-Kareh R, Goel A, Vineet FN, Chapman WW. An approach to improve LOINC mapping through augmentation of local test names. Journal of Biomedical Informatics 2012;45:651-7.
Goel A, George J, Burack RC. Telephone reminders increase re-screening in a county breast screening program. Journal of Health Care for the Poor and Underserved 2008;19:512-21.
Goel A, Littenberg B, Burack RC. The association between the pre-diagnosis mammography screening interval and advanced breast cancer. Breast Cancer Research and Treatment 2007;102:339-45.
Selektor Y, Dhabuwala J, Bazzy K, Hanane T, Wiese-Rometsch W, Goel A. Developing a simpler measure of diabetes care quality. Journal for Healthcare Quality 2006;28:53-59.
Goel A, Christy ME, Virgo KS, Kraybill WG, Johnson FE. Costs of follow-up after potentially curative treatment for extremity soft-tissue sarcoma. International Journal of Oncology 2004;25:429-35.
Goel A, MacLean CD, Walrath D, Rubin A, Huston D, Jones MC, Niquette T, Kennedy AG, Beardall RW, Littenberg B. Adapting root cause analysis to chronic medical conditions. The Joint Commission Journal on Quality and Safety 2004;30:175-186.
Goel A, Pinckney RG, Littenberg B. APACHE II predicts long-term survival in COPD patients admitted to a general medical ward. Journal of General Internal Medicine 2003;18:824-30.
2017 – present American Health Information Management Association, Board Advisor
2015 – present Wired Informatics, Advisor
Provide the start-up with clinical feedback to refine their product roadmap based on what health care customers would expect to use in the short- and long-term. Interact with programming team to iterate their products from concept to working prototype for clients to review. Use cases include:
- Refine copy-and-paste software to highlight users with a proportion of similar notes across a single encounter.
- Specify missing required elements from operative reports to reduce the risk of a compliance audit.
- Use text filters to identify patients with specific diagnoses prior to a clinician placing the diagnosis in a discrete field to meet external reporting requirements and advance internal quality initiatives (i.e., stroke, congestive heart failure)
2014 – present American College of Physicians Journal Club, Associate Editor
2014 – 2016 National Baldrige Performance Excellence Program Examiner