Improved Care: An Interview with Dr. Salvatore Volpe
Salvatore Volpe
Salvatore Volpe, MD, FAAP, FACP, CHCQM, has 20 years of primary care practice experience. He is one of the few physicians in the country to have successfully become board certified in pediatrics, internal medicine, geriatrics, and quality assurance. From 2009 to 2011, he is serving as HIMSS New York Chapter president. In 2009, his became the first solo practice in the state of New York to achieve Level 3 National Committee for Quality Assurance Patient Centered Medical Home Recognition.
Q: What do you enjoy most about your chosen field of medicine?
A:I take care of everyone, from teenagers to people over 100. I like to look at the whole family and get a gestalt, not only for the person physically, but also how they fit into their environment.
Q: You speak nationally about health information technology. When did you begin to realize the potential for utilizing information technology in medicine?
A:When I completed my residency, I took a part-time job with a managed care organization. Part of the training involved learning what information was available on patients and practices. I was impressed with the breadth of data but also with the limitations of paper reports. I thought, imagine what I could do for patients if I had real-time access to their medical records. There were some innovative solutions being developed, but at the time they were very expensive. Today, using cloud computing, you can achieve with a couple of workstations and an Internet connection what used to take thousands of dollars in hardware and software.
Q: How does HIT affect quality of care?
A:E-prescribing is the low-hanging fruit. It helps physicians avoid major problems with drug-allergy, drug-drug, and drug-disease interactions, and because databases are updated more quickly than print publications, it also provides access to the very latest research. It's great for patients because even a savings of $5 to $10 on a copay for a clinical alternative can make a big difference.
Another example is non-medication clinical decision support. Non-obtrusive reminders related to smoking, hypertension, hyperlipidemia, and diabetes can assist the provider in choosing appropriate diagnostic studies and treatment options, and helping the patient make better lifestyle choices.
"You can't just give physicians a mandate to update technology. We need to invest in helping them offset the costs of hardware/software, but also the cost of time. You can't be bound to the economic cost if you are to provide the best care."-Salvatore Volpe, MD, FAAP, FACP, CHCQM
Q: What areas of innovation in HIT do you find most exciting?
A:The patient portal is a wonderful means to help the patient and his or her family become part of the care management team. Imagine you have patients, a couple in their 80s with kids in their 60s who live in Hawaii. The kids can stay on top of what's going on with Mom and Dad by logging into the portal. Medicine, for all its high-tech advancements, is very archaic when it comes to recording. Two or three years ago, electronic health records were so hard to navigate that you couldn't complete a note before the patient walked out. Today's advancements save patient time and physician time, and make for a better visit. Access to the record is an opportunity to refresh one's memory about the current treatment plan, examine pending recommended treatment items, and correct transcription errors.
Mobile computing will make it easier for providers to render care in a timely fashion as well as provide patients with personal health information whenever it is needed.
Q: Are you concerned about security?
A:We cannot make light of the need to maintain security and to respect the privacy of our patients. The most secure record is a paper one in a vault, but then you wouldn't have the advantages of information exchange. We have to open the door a bit, because the pros outweigh the cons. There may be breaches, but for every breach there will be 10,000 instances where people benefit.
Q: Which areas of healthcare delivery, in your opinion, are most in need of investments in innovation?
A:We need to provide better health information and education to patients of all ages. Improvements in education coupled with access to affordable, healthy food and exercise could potentially improve general health. You can't just give physicians a mandate to update technology. We need to invest in helping them offset the costs of hardware/software, but also the cost of time. You can't be bound to the economic cost if you are to provide the best care.
Q: What is extraordinary about the New York chapter of HIMSS, and how have you helped to contribute to the success it enjoys?
A: We are fortunate to have one of the largest and most diverse chapters in the country, and we have a great team of volunteers who contribute selflessly. Within the past year, we launched LinkedIn and FacebookTMinitiatives to improve communication. We held a student informatics conference that brought students and educators together with potential employers. We initiated several new committees to bring dentists, nurses, attorneys, and others into the fold. Our border chapters agreed to join in a cooperative relationship to expand options to HIMSS members in the region. That approach has resulted in a terrific cross-pollination of ideas and resources.
Q: Who has influenced or inspired success in your career the most and why?
A: My parents were hard workers of modest education, but they always tried to help people. They gave me an incredible sense of empathy, which is invaluable to me as a healthcare provider. When people are hurt, you don't feel right unless you try to help them. You have to share what you know but you also have to be willing to listen to others, take what you've learned, and pay it forward.
