The Digital Patient

206: MHS’ ACMIO Dr. Michael Weiss: Fixing "Rogue" Clinical Notes, Designing Workflows for Rare but High-Risk Events, and Applying Goldilocks Principles to Governance

Dec 9, 2025
Dr. Michael Weiss, Associate Chief Medical Information Officer at Memorial Healthcare System and a dedicated pediatric emergency physician, shares his innovative insights on clinical documentation. He tackles the issue of 'Rogue Notes'— inconsistencies in clinician templates that jeopardize safety and compliance. Weiss presents strategies like dynamic documentation guardrails and using AI for better workflows. He also emphasizes the importance of designing for rare, high-risk events and the delicate balance of governance in healthcare informatics.
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ANECDOTE

Single Button CPOE Success

  • Early in his career Michael built CPOE for pediatric emergency medicine and reached ~97% compliance from a single button.
  • That experience taught him the power of a well-placed, trusted EHR control.
INSIGHT

Rising Cognitive Load From Data Explosion

  • Cognitive load on clinicians is rising rapidly as more data and integrations flood workflows.
  • Better organization and presentation of information reduces provider overload and improves patient care.
ADVICE

Rebuild Notes With Guardrails

  • Tear apart documentation to identify required elements and rebuild notes with mandatory data points.
  • Allow provider customization only between mandated ‘guardrails’ to balance safety and voice.
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