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Analysis

Novant CMO Draws From His Aerospace Background to Reduce Patient Harm

By Christopher Cheney  
   December 10, 2018

The physician executive's goals for the CMO role include fostering a high-reliability approach to care and using artificial intelligence to reduce medical errors.

Eric Eskioglu, MD, the newly appointed executive vice president and chief medical officer at Novant Health in Winston-Salem, North Carolina, says his main focus in his new role is reducing patient harm and using artificial intelligence to do it. His solution can be correlated to his background as an aerospace engineer.

Eskioglu worked on fluid dynamics models in the aerospace industry, focusing on jet engines and how they interface with airplanes before he became a vascular neurosurgeon.

“That was my transition to medicine—working with fluid dynamics models and turbulence from jet engines and now looking at the blood vessels in the brain. It's all dynamics—whether it be gas or liquid," he says.

Eskioglu's aviation engineering career included working at Boeing in Seattle. He began his neurosurgical career at Vanderbilt University Medical School, where he was an assistant professor of neurological surgery.

He joined Novant in 2015 and expanded the health system's neurosciences program from 35 to 82 providers.

HealthLeaders recently spoke with Eskioglu, who officially began his CMO role in October, to find out about his leadership goals. Following is a lightly edited transcript of that conversation.

HL: What are your primary goals in the CMO role?

Eskioglu: Most CMO roles are traditional. They keep up with the regulatory environment, and they make sure the medical staff works well. Obviously, I have to maintain those parts of the CMO role, but I want to reinvent the role at Novant Health.

We want to get into strategy—how we build strategy for the clinical team and enable people to think about artificial intelligence. Because of my engineering background, I am extremely interested in AI. Medical knowledge doubles rapidly and the doubling is accelerating—our doctors are going to have a huge issue coping with this avalanche of knowledge, but we don't have the gift of time. Everybody talks about physician burnout—that's one of the reasons. We are getting so much data where we just can't cope with it.

My goal with AI is to work with the technology leaders—it could be Microsoft, it could be Google, it could be Apple—and team up to automate some of our processes with not only machine learning but also artificial neural networks. I want to be able to give back the gift of time to physicians, so we can lessen physician burnout, which will help us improve quality and efficiency as well as cut costs.

HL: How can AI have an impact in clinical care?

Eskioglu: One of my biggest goals in the CMO role is predicting which hospitalized patients are going to get sick before they get sick. Once they get sick, you can't turn back the hands of time.

We get so much data from our EMRs, but we don't use that data efficiently. We don't know what to do with that data. That's where artificial intelligence with machine learning can help. Using algorithms, we can see a chest x-ray does not look good or fevers are going up. Then, looking at past medical history we can see when patients got infected before and know that they are at risk. Doctors can then be alerted to look closely at these patients.

That kind of approach will sharpen our clinical expertise and reduce clinical errors. Nationwide, about a third of our medical care involves clinical errors. That's a huge amount of money we lose every year and a huge amount of patient suffering. We want to end that suffering. Patients come here to get well, but about a third of them get sicker because of what we do. That's not just at Novant—that's everywhere.

HL: What constitutes a good physician leader?

Eskioglu: The physician leader is a constantly evolving role. There are many challenges—governmental, clinical, and personality.

The biggest thing I have learned over the years as a physician executive is you have to listen more than you talk. That's tough for physicians—when you go to a doctor's office, who does most of the talking? It's the doctor, not the patient.

Another part of physician leadership is being collaborative. At medical school, we are taught to be the captain of the ship; but when you are a physician executive, you can't go it alone. You need to collaborate with different parts of the organization—whether it be your HR counterparts, your IT counterparts, or your chief nursing officer.

HL: What are the biggest opportunities for quality of care improvement at Novant?

Eskioglu: Our focus as a team is going to be zero tolerance for hospital-acquired infections, for serious safety events, and for any kind of harm we can do to patients while they are in the hospital. It's going to take some discipline and a methodical approach. I do not have a magic wand that I can wave and achieve change overnight.

This is our biggest focus now, and we will be teaming up with our digital chief executive. We are excited about bringing artificial intelligence to this effort and being able to use billions and billions of data to reduce errors.

I get told that it can't be done. I hate that phrase. It can be done. It's been done in the aerospace industry and we definitely can reduce errors in the healthcare industry.

We also are going to look at the quality of all physicians. Today, you can look for a car and see which car is best, but you can't do that for physicians. Patients don't have a good way to look at physicians.

We want to get a better handle on how we can improve the quality of our physicians and how we can lower costs. When my surgeons operate, they have no idea about what their surgery cost. When they get out of the operating room, our goal is to give them a receipt that quotes their charges, how much the total operation cost, the amount of time they spent, how they compare with their peers within Novant, and how they compare with their peers outside Novant.

We want to be transparent with our physicians. That should improve what we do tremendously.

Christopher Cheney is the senior clinical care​ editor at HealthLeaders.


KEY TAKEAWAYS

Eric Eskioglu, who recently became CMO at Novant Health, started his career as an aerospace engineer then became a vascular neurosurgeon.

Eskioglu believes artificial intelligence can ease physician burnout and reduce clinical errors.

He says good physician leaders are adept at listening and collaborating.


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