Deploying technology, enhancing care: Q&A with Carleen Penoza, MHSA, B.S.N., R.N.
Carleen Penoza, MHSA, B.S.N., R.N., became Michigan Medicine’s chief nursing informatics officer in April. As CNIO, she leads the strategic planning and deployment of technology for nursing.
She previously served as the director of inpatient applications and interim senior director for clinical and operational applications in Health Information Technology & Services (HITS).
Headlines recently caught up with Penoza to discuss the challenges and opportunities in her new role.
Q: Prior to becoming CNIO, you held several IT leadership positions. How did that background prepare you for this role?
CP: Working effectively with HITS and the Office of Clinical Informatics is essential to our success in Nursing Informatics. As a former leader in HITS, I recognize what it takes to support complex technologies at an academic medical center. Similar to the multidisciplinary approach used to care for patients, there are many different teams and skills needed to run an IT department. Everyone is responsible for their specific “cog” in a very large wheel in order to maintain and secure the systems we rely on every day. I respect the hard work done by HITS team members, and I look forward to a continued partnership to bring the best technologies to our clinicians and patients every day.
Q: What are some of the responsibilities and challenges facing CNIOs today?
CP: Michigan Medicine’s amazing nurses are at the center of what makes our system a national leader. My foremost responsibility is to them — to deploy technology that puts them in a position to deliver world-class care for our patients. The pace of change related to health care and IT is astronomical! CNIOs need to analyze the market for new technologies and identify which solutions will improve care delivery. We want to be innovative and bring great ideas quickly to our clinicians, but sometimes it is difficult because the technology may not meet their expectations. For example, we are just beginning to scrape the surface of how to meaningfully embed technologies like predictive analytics or artificial intelligence into patient care. At the same time, we still heavily rely on older technologies, like paging and faxing. These challenges make Nursing Informatics an exciting place to work!
Q: Michigan Medicine has used MiChart, the electronic health record, for about six years. There’s a lot of discussion around improving workflow and usability, and trying to ease the documentation burden on nurses and providers. How can we address this?
CP: When computerized documentation replaced paper-based workflow, it became easy for well-intentioned leaders to require nurses and other clinicians to document more and more aspects of care delivery. It was meant to improve quality and meet regulatory requirements. The unintended effect of burdening nurses with these documentation expectations can detract from direct patient care — the core of our nursing practice. It is time to step back and reassess what is really driving outcomes and quality — and minimize EHR activity that doesn’t do this. In addition, we know lengthy training sessions aren’t the most effective way to teach nurses how to use MiChart. We are reviewing the onboarding process to provide more efficient initial training, and then additional support focused on efficiency.
Q: We have more access to more data than ever before. How does data and analytics affect the nursing profession? What can nurses do with this influx of data and how can it help them improve patient outcomes?
CP: We have a lot of data, but we’re still learning how to leverage it all to gain knowledge and inform decisions. Nurses are critical stakeholders in advancing analytics-driven care delivery. If we do a good job designing the EHR, we can capture key data that can be used to reduce patient risk and support proactive treatment. There are some excellent examples — handwashing, CAUTI and CLABSI — of how data changed organizational behavior and made care delivery safer and more efficient. We currently use MiChart data to run predictive analytics algorithms to find patients at risk for sepsis, forecast future census, and predict the number of discharges. We collect an immense amount of data through the EHR and will continue to improve both care to individual patients, as well as the efficiency of our operations.
Q: What will health care look like in five years? What’s it going to take for Michigan Medicine to get there?
CP: We need to rethink what care needs to take place within the walls of the hospital versus how we can provide personalized medicine for our patients wherever they are. Michigan Medicine’s virtual care initiatives are moving us in this direction. We offer virtual visits through the patient portal, monitor patients remotely via data they upload from home medical devices, and text care reminders to patient cell phones. I’m also excited about our “Unified Clinical Communications” initiative to (finally!) begin the journey to eliminate pagers. We will utilize smartphones for secure text, talk, MiChart documentation, and to receive alarms and alerts. I also feel very lucky to be able to partner with researchers and educators in the School of Nursing, who are envisioning what the future of nursing looks like. Michigan Medicine is primed to lead the future of health care IT.
Q: What activities or hobbies do you enjoy outside of work?
CP: I consider myself a “hockey mom” — however, that really means I’m a hockey, orchestra, band, tennis and baseball mom, among other things. Family is my first “hobby,” but I also love to travel, bike and ski. My family enjoys visiting national parks to experience the beauty of the U.S.