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Ahmad Sharif, MD – Fresenius Medical Care

Small changes save lives and improve outcomes

During his days as a surgeon, Dr. Ahmad Sharif’s family couldn’t have been prouder. He’s performing miracles, they thought. Changing lives forever. So when Sharif decided to switch gears and enter health care IT, their reaction was strong. Why, they wondered, would he stop doing something that helped so many?

Today, those loved ones may understand what Sharif knew all along: that by doing one small thing through technology, and doing it right, one can make a difference in the lives of thousands of people.

Ahmad Sharif, MD – Fresenius Medical Care

As the chief medical information officer for Fresenius Medical Care (FMC), a vertically integrated organization specializing in the treatment of chronic kidney disease conditions, Sharif is bringing that perspective to bear on one of medicine’s most challenging sectors.

That those chronically ill patients, many of whom have End Stage Renal Disease (ESRD), require some of the most intensive treatments in the field, from regular dialysis infusions to costly medicines, and hefty regulatory imperatives, only makes the calculus more complicated.

“I wake up every morning thinking about how we can make things more efficient and safe for our patients and staff,” Sharif says. “In this day and age, if your goal is to improve outcomes efficiently, you have to create a technological environment that fosters that.”

A mounting challenge

Among other initiatives, FMC is working to upgrade its traditionally paper-based clinical plan of care—a critical guiding tool for dialysis patients—to be entirely electronic.

After efforts to find the right vendor ran aground, Sharif and his team decided instead to develop the idea internally—specifically, alongside FMC subsidiary, Fresenius Kidney Care’s (FKC) existing electronic medical records system (EMR).

While the first phase of the overhaul done, Sharif insists the resulting protocol will improve processes at every level of the doctor-patient relationship, with everyone from dieticians and social workers to doctors contributing to the resulting plan.

“We want to make sure these plans serve the staff as well as the patient,” Sharif says. “Rather than it being an extraneous, box-checking exercise that may or may not get done, the goal is to create a seamless workflow and tool, where the care-providing team can collaborate towards better care planning for the patient.”

Information Sharing

According to Sharif, in a perfect world, all relevant data would be interconnected and available to the right person at the right time, so as to mitigate instances of redundancy and duplication—of procedures, medication, labs or anything else.

With 2,300 dialysis centers in seven different time zones, FMC continues to be a national leader in renal care, with cutting-edge technology and continually groundbreaking research.

Ahmad Sharif, MD – Fresenius Medical Care

The flip side, however, is equally massive: When you’re rolling out changes that affect 70,000 employees and more than 200,000 patients, diligence and detail matter—particularly when it comes to coordinating care with hundreds of other health care entities.

To that end, Sharif encourages more meaningful and timely data exchange with other care providers, not only to keep better track of their patients’ treatment, but to help promote better outcomes and lower costs.

Unfortunately, the current dynamics make it difficult to access patient information outside the four walls of FMC’s treatment centers—a gap he says the company, given its size and scope, is uniquely positioned to address.

“The promise of technology has always been in how it encourages and facilitates communication,” Sharif says. “By connecting the information highways we have, we can create transaction systems that reduce redundancy and provide a more comprehensive picture of patient care.”

One of the most important of these information highways is Acumen, an EMR developed internally—“by nephrologists for nephrologists,” notes Dr. Sharif—and the only of its kind to receive Meaningful Use certification from the Office of the National Coordinator for Health Information Technology.

A nephrologist is a kidney specialist.

In an effort to modernize the program’s backend platform, FMC partnered with Epic—the electronic-records software which houses medical records for almost half of the U.S. patient population—to create Acumen 2.0 powered by Epic.

Beyond improving interoperability and scale, the upgrade allows FMC to document, store and supply information on behalf of 2,500 nephrology providers around the country, giving them tools to support their treatment of kidney ailments and diseases.

By participating in tools like CareEverywhere, Acumen 2.0 gives users a cross-section view of their patients, while fostering better coordination and collaboration among the various care providers.

Through efforts like these, Sharif says you can improve outcomes and access, prevent errors and save lives.

For Sharif, improving FMC’s overall functionality requires making those processes nimble enough that they can be constantly tweaked, such that what’s being developed is directly aligned with the company’s overarching needs and goals.

In order to achieve that efficacy, however, Sharif says hospitals and other providers must embrace their profession for the “team sport” that it is—one where clinician input into IT initiatives is not only welcomed, but encouraged.

Proper input

While attending a summer school program at Harvard University, Sharif was asked to review surgical notes for use in an EMR. What he found was a methodology woefully lacking in the most important of inputs: that of the physicians.

“These notes were being generated primarily for billing purposes, without looking at how it impacted the end user,” recalls Sharif, who eventually earned a master’s in health care management and policy. “That’s how I got into health IT, to get clinicians more involved and in control of developing the systems they use on a daily basis to render care.

As technology continues to mature, and with industry reform focused more and more on issues of value, Sharif says there’s a growing interest from health care entities to exchange data and collaborate—a dynamic FMC is more than willing to support.

A self-described proponent of “user-centered design”, Sharif has created a number of working groups and councils designed to help doctors, nurses and practitioners more effectively engage with the projects as early as the design stage.

However crucial that collaborative component has become, as medical care has grown increasingly technology-dependent, Sharif says there’s a growing need for people who understand the nexus of IT and medicine—even if the surgeon in him will always place primacy on the latter.

“Initially, you had practicing doctors spending whatever spare time they had on medical information and informatics.” he explains. “Now that dynamic has changed—the field of full time clinical informatics is burgeoning. But I think it’s important that the clinical aspect and user experience serves as the guiding North Star in helping our patients and providers.”

Published on: March 22, 2018

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