Defining informatics for health center teams

I just ran across this great short post on informatics and had to share it. I wish Dr. Gibson had written this post a couple years ago when I first used the word “informatics” with my new health center colleagues. When I said the word, I might as well have been speaking Klingon — no one knew what it was — not the clinicians, the business folks, operations… no one had heard the term. Of course it didn’t help that I recommended we consider hiring an informaticist — a new position that no one knew they needed and couldn’t define. ;-)

At the time, and to some degree even today, there was an expectation that mainline IT staff would fill the role of informaticist for the company. And in some small ways, we do. But not in the big ways, not in transformative ways. Our IT staff are saddled with basic systems maintenance, user support, new system installation and integration efforts, and so on. We’re not clinicians by training. While we listen and learn a little every day about our clinical operations, we’re still not doctors or nurses. (Funny how that works.)

So what is informatics? What does an informaticist do? Dr. Gibson explains it like this (boldface mine):

Important informatics skills include change management (not just IT change management, but culture and process change management as well), business analysis, stakeholder engagement, project management, requirements development, strategic thinking to place projects into a larger vision, building for inter-operability, translating between IT & business, system life cycle, communications, [etc.]). A good informatician can speak the language of both IT staff and program staff, and should be a good communicator and group facilitator.

Informatics skills are not necessarily present in IT departments. A programmer may be very skilled in writing a program to do what he wants, but is rarely skilled in getting the thorough understanding of what users need. The database administrator may be very skilled in structuring a database to run very quickly, but usually does not understand the content well enough to create operational definitions that address what program managers want to know.

My recommendation from a couple years ago was that we needed to hire an informaticist, or at least someone who had clinical background and technical chops. With all the reporting and analysis requirements in UDS, Meaningful Use (MU), and Patient Centered Medical Home (PCMH), not to mention workflow changes needed to meet increasing security and privacy requirements (HIPAA, HITECH) and general efficiency needs, having someone who could drive workflow / care / data change projects and communications would help a lot.

In the end we didn’t hire a classic informaticist, but we do have a high-level manager driving Quality Improvement (QI) efforts, PCMH, and MU, and she’s quite technically capable as well as a licensed provider. So we’re covering the need for now.

It’s possible that at our scale (currently around 130 employees), perhaps a full-blown highly-paid informaticist won’t be necessary in the future. It’s possible the EHR vendors and various governmental agencies will settle on a collection of core measurements and workflows that work for everyone and those features will just be built-in to our systems. (Ha! Sometimes I crack myself up…)

But for now, I would argue everyone in the health center space (50-500 employees) needs to be thinking about hiring an informaticist. Someone that has clinical training. Someone that isn’t afraid of computers and likes data and analysis. Someone that can communicate well and can drive change projects. So yeah… a miracle worker!

Meanwhile, everyone on your management team needs to know what informatics is. Your health center needs to get comfortable with data and change. Because “accountable care” demands proof, and the proof is in the data.

BONUS: Informatics Links