Clinician Profile: Bertina Yen, MD, MPH

Bertina Yen, MD, MPH, is director of content development at Zynx Health.

Your position at Zynx is director of content development. Can you give us an idea of what a typical day in this role entails?
 
I sometimes joke that my “triple threat” at work is meetings, management, and e-mail. My responsibilities include oversight for the development and maintenance of three of the newer Zynx product lines: ZynxCare, Zynx AmbulatoryCare, and Zynx ObstetricCare. I currently have three direct reports and 11 indirect reports, many of whom work outside of the Los Angeles office, so much of my time is spent ensuring their satisfaction and success at Zynx.

A typical day for me includes generating and responding to a lot of correspondence on a variety of topics by e-mail, phone, and in person with content team members, employees from other departments, and external clients. For example, I may field questions about our standard operating procedures for developing content from a new writer, respond to inquiries about our content rollout from a sales manager, and explore potential collaborative opportunities with a client, all on the same day. Leading or attending meetings with content team members, other department heads, and business partners rounds out my week.

One major perk of my position is the variety of tasks I get to be involved with, such as exploring ways to improve our content and make it relevant to a variety of audiences, expanding our business opportunities with EMR [electronic medical record] vendors, and meeting with clients to better understand their clinical decision support needs.

When and how did you first decide to become a physician?

My initial interest in medicine was shaped by my father, who worked as an obstetrician-gynecologist in a solo practice in a small town in Ohio. I could see firsthand the positive impact he had made on his patients and in his community. My desire to work in healthcare continued though my college days at Stanford University, and I ultimately completed my medical school and internal medicine training at the University of California, San Diego.


You received an MPH degree in Health Services from UCLA. How does your training in public health inform the work you do at Zynx?

Prior to entering medical school, I knew that I wanted to supplement my clinical training with exposure to strategies that could impact patient care at a community level. I first found out about Zynx during my public health training at UCLA, where I received my Masters of Public Health degree. The work that I do at Zynx, influencing clinician behavior through evidence-based clinical decision support, is a natural extension of my public health training and allows me the opportunity to affect the care of patients for our more than 1,400 hospital clients which represent more than 40% of hospital admissions in the US.

“My initial interest in medicine was shaped by my father... I could see firsthand the positive impact he had made on his patients and in his community.”

What do you enjoy most about the work that you do at Zynx?

I began working at Zynx six years ago as a subcontractor and became a full-time employee five-and-a-half years ago because I was drawn to and respected the people who worked here (many of whom, including senior management, still work here). I have stayed at Zynx because of the quality of people we continue to bring to the organization. We are fortunate to be able to attract people who are not only committed and passionate about improving healthcare, but also fascinating to talk and work with.


How has Zynx evolved since you joined the company?

As we have grown, we have become more disciplined in our processes across the organization.

When I joined Zynx, the company had just begun its transition from being solely a referential content provider to becoming a more robust source of point-of-care clinical decision support.  That transition involved not just the evolution of our evidence-based content to meet this new format but also focused our attention and resources on the health IT requirements that were needed to make our products successful and usable within our vendor EMR partners.

With our large and growing client base, we have expanded our client services department tremendously to enable our clients to utilize our products to their fullest capacity.


What was it like to transition from work as a practicing physician to your role as a content developer at Zynx?

During my first two years at Zynx, I continued to work clinically in the urgent care on nights and weekends. The ability to maintain some level of clinical interaction is encouraged at Zynx since those experiences help us to improve our content and its usability in a real world setting. After the birth of my first child at the end of 2003, I began to cut back on my clinical shifts and was faced for the first time with the dilemma of whether I could maintain my clinical skills to my satisfaction and comfort level, in addition to working at Zynx and fulfilling my family responsibilities to my fullest capacity. My ultimate decision to stop working clinically altogether has helped me to maintain a reasonable work/life balance at Zynx and at home, and is one that I have made with no regrets. 

One of your current areas of focus is developing content for use by primary care providers. Can you tell us a bit about Zynx’s AmbulatoryCare product and your role in its development?

Zynx AmbulatoryCare consists of clinical decision support content geared towards primary care, health maintenance, and disease management. It rounds out our product suite and better positions our clients to address the full continuum of patient care, that is, inpatient and outpatient. Similar to our hospital products, Zynx AmbulatoryCare applies an evidence-based methodology to develop content that focuses on clinical processes that improve the quality and efficiency of patient care and helps our clients identify those processes that are included in a variety of quality improvement and pay-for-performance initiatives.

My clinical background and interests before I joined Zynx were centered around outpatient medicine and primary care, so I was excited to be able to take a leading role in the development of the Zynx AmbulatoryCare product, including the writing and oversight of much of the early content. My current responsibilities for the product are to identify and work with ambulatory EMR vendor partners to utilize our content within their systems and bring evidence-based clinical decision support to the point of care for our shared client base. In addition, I serve as the main source of clinical support for this product to our sales and client services teams.

“My clinical background and interests before I joined Zynx were centered around outpatient medicine and primary care, so I was excited to be able to take a leading role in the development of the Zynx AmbulatoryCare product.”

What kinds of challenges are specific to physicians in outpatient office practices? How does Zynx AmbulatoryCare help them tackle those challenges?

One of the biggest challenges facing outpatient physicians is determining strategies to optimize a busy practice and maximize reimbursement. In addition, there is a growing number of quality reporting initiatives that track an individual physician’s adherence to a variety of “best practices” and that are made publicly available to his/her patients and peers.

Zynx AmbulatoryCare addresses these challenges by developing and packaging its content to be used as part of the workflow for a busy clinical practice. For example, the content includes checklists and order sets that can be used at the point of care, as well as referential material that can be reviewed in more depth by a physician after all the patients have gone home. In addition, the content can be used on paper, on the web, or directly within an ambulatory EMR system. Finally, we regularly monitor those performance measures which are included in pay-for-performance programs and/or quality report cards that impact the physician office, enabling our clients to identify, prioritize, and implement strategies to improve their performance in those programs.

In the past, Zynx’s evidence-based solutions have focused mainly on the acute care setting. Why is it important to extend the reach of these solutions to the outpatient realm?

In order for patients to maintain the benefits of standardized evidence-based care that they receive in the hospital, they need to receive similar appropriate follow-up and chronic management care in the outpatient setting. For example, if a patient who is discharged after an acute exacerbation of heart failure is not maintained on the appropriate medications—for example, ACE inhibitors, beta-blockers, or diuretics—at home, he/she will quickly end up in the hospital again needing treatment. By providing a suite of clinical decision support products that share a common evidence-based methodology, our clients can ensure that their clinicians are getting consistent information on best practices in the inpatient and outpatient setting and that their patients are being treated optimally across the continuum of care.

You are also working on developing evidence-based content for use by perinatal care providers. Tell us more about your work in this area.

In 2007, we launched a referential product called Zynx ObstetricCare that is accessible within GE Healthcare’s Centricity Perinatal Clinical Information System. This partnership with GE Healthcare represents Zynx’s first foray into providing clinical decision support within electronic monitoring devices for pregnant women and neonates. The content covers topics relevant for obstetric providers who provide care throughout a mother’s pregnancy—that is, prenatal, intrapartum, postpartum—and for neonatal providers who provide care for infants in the newborn nursery or neonatal ICU.

What are your interests outside of work? What keeps you occupied in your spare time?

I keep pretty busy as a mother of two young children. Natalie, my daughter, is four years old and Quincy, my son, is one year old. When I have the opportunity, I like to catch a movie or a play with my husband and plan for the next family trip. For 2008, we will be going to the US Virgin Islands for a week, including some time near the Virgin Islands National Park.

Bertina with her daughter, Natalie,
who recently celebrated her
fourth birthday.