Matthew Ewend is focused on patient and caregiver experience as well as balancing academic and community medicine.
The leading 2024 priorities for the chief clinical officer at UNC Health include improving the experience of patients and care providers.
"We want to make the experience of delivering healthcare and receiving healthcare better," says Matthew Ewend, MD, chief clinical officer of UNC Health and president of UNC Physicians. "Right now, it is not much fun to deliver healthcare and for many of our patients it is challenging to enter into the system and to get healthcare."
1. Supporting caregivers
Ewend says his number one priority is supporting his clinical care team.
"I want to use the position I have to ease barriers for my staff," he says. "I use the analogy of football, where the pulling guard is out blocking. I want to clear the path and break down barriers, so that the people on my team can work on things such as quality, high-value care, improving our clinic functions, and getting services to patients in rural areas who do not have access to care."
Technology such as artificial intelligence can improve the caregiver experience, Ewend says.
"For example, when I am in my clinic, I put my phone down on the desk, then I ask my patient's permission to use ambient listening," he says. "It listens to the conversation with the patient, and it generates a note. By the time I get back to my work station, I have an AI-generated note about the patient encounter. It is organized with the patient history, what I found during the physical exam, what tests such as X-rays showed, and the plan of care. It is not perfect, but it is better than me typing a note. This is an example of making it easier for providers to deliver care."
Managing messaging on the health system's patient portal is another way Ewend wants to support clinicians.
"When we created the patient portal, people thought we were creating a means to send messages to providers like they were messaging a friend. Patients felt they should be able to message anything at any time and get an answer back right away," he says. "So, we have set expectations for our patients. You can expect an answer within three business days, and you should ask questions that are a continuation of care that you have received. Some of the answers might be that the patient needs a virtual appointment, a phone call, or an in-person visit. So, we set expectations with our patients, and we set expectations with our doctors. We want our doctors to answer these questions, but we understand they cannot answer patient portal questions within 10 minutes."
By setting expectations and using technology and support staff to screen messages, UNC Health has been able to reduce the number of patient portal messages being sent to clinicians and decrease the amount of time clinicians are spending tackling messages, Ewend says.
"More importantly, we have made it so when a message reaches our doctors, it is only something the doctor can answer," he says. "They do not get messages about a patient expecting to be 15 minutes late for an appointment. That may be good to know, but it does not need to come to the doctor—it should go to someone else on the team."
Matthew Ewend, MD, chief clinical officer of UNC Health and president of UNC Physicians. Photo courtesy of UNC Health.
2. Patient experience
From the patient standpoint, Ewend wants it to be easier for patients to find their way to the right provider, at the right place, with the right expertise.
"The analogy we use is air travel. You can go online and book a flight to China on your phone, but it can be difficult to book an appointment with your primary care doctor," he says. "The problem is we are comparing receiving healthcare to a single, episodic event. It is easy to order protein powder from Amazon, but that is a much simpler thing to deliver than a kidney transplant."
To apply the consumer expectation that healthcare is going to be instantaneously available and at the patient's fingertips is very complicated, Ewend says.
"We want to offer online scheduling," he says. "We want patients to able to access their providers in a thoughtful way and to be able to get information about their care through patient messaging, but we know when that is done badly it overwhelms our providers."
3. Balancing academic and community health priorities
Ewend plays a role in balancing UNC Health's academic mission with its commitment to serve communities across the state of North Carolina.
"We want to be at the forefront of academic discovery, research, training the next generation of healthcare providers, and providing complex subspecialty care. But we also have the mission of serving the entire state of North Carolina and improving the health of the people of North Carolina," he says. "So, our health system is trying simultaneously to serve all the people of North Carolina and also to be at the forefront of developing new knowledge, new technology, and new research breakthroughs, as well as training the next generation of care providers."
Harnessing the collective power of the health system's academic and community physicians is among Ewend's top priorities.
"I want to clear the path so that our community physicians, who are a crucial part of our mission, are able to do the work that they do, which is providing high-quality care close to patients in their hometowns. At the same time, I want to support our academic group in doing groundbreaking research, training, and providing the quaternary care that they do."
Christopher Cheney is the CMO editor at HealthLeaders.
KEY TAKEAWAYS
UNC Health is using technology such as ambient listening to support clinicians.
Managing messaging on the health system's patient portal is essential for clinician and patient experience.
UNC Health's CCO plays a role in balancing the health system's academic mission with its commitment to serve communities across the state of North Carolina.