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

Updated ‘quantified self’ gear coming this year

The quantified self movement keeps chugging along, with updated tech announcements coming from both Withings and BodyMedia this week.

BodyMedia will introduce an updated version of their arm-mounted health data collector, theoretically shipping in August. The new version is quite a bit more attractive than the current one. It measures activity / movement, sleep patterns, and calories burned. It competes with the Nike+ FuelBand, the FitBit One, and others.

Withings, who first arrived on the scene with a Wi-Fi weight scale, is introducing an updated scale — the Smart Body Analyzer — but also an activity monitor — the Smart Activity Tracker — to compete with FitBit and all the rest. It’s not clear when these products will ship, though Withings is claiming a Q1 release.

The Smart Body Analyzer is the most interesting addition to the field, as it’s bringing more sensors to the party. This thing will get your weight and body fat percentages, like the current model, but it will also capture heart rate and — this is the amazing bit — air quality, in terms of CO2 levels in the ambient air. Captured data syncs via Wi-Fi or Bluetooth, and naturally goes into their cloud-hosted data monitoring system and smartphone apps. You can sync over to Microsoft HealthVault if you like.

Personally, I’m wearing a Nike+ FuelBand right now and I love it. It actually think the FitBit is more accurate, but the FuelBand goes on your wrist and stays there — you don’t lose it off your belt or send it through the wash in your pants. The only one I really want to try out is the Jawbone Up, which has more features than the FuelBand, but lacks the FuelBand’s integrated data display.

Meanwhile, check out this article from AllThingsD on the trends in the space:

Fitbug pitches employers and launches new activity, weight, and blood pressure gear [UPDATE]

[Update at bottom of post]

This is a new one on me. I follow the “quantified self” market fairly regularly, but it’s the first time I’ve seen activity tracking devices and services being pitched directly to employers.

The idea: As an employer, you want to encourage healthier behaviors, in order to drop your insurance costs. With Fitbug, now your company can hook up with them to provide units to staff and track progress individually and as a group.

The site offers relatively little information and no real studies of effectiveness. But it’s an intriguing idea — one that’s likely to gain traction in the next few years as devices get cheaper and employers (and health insurance carriers) get employees and customers more engaged in health management and promoting healthy behaviors.

New Fitbug Gear

Meanwhile, Fitbug is introducing a bunch of new gear, including the Fitbug Orb, a low-cost ($50) Bluetooth-connected activity tracker (that’s not currently shown on their own web site). They also have a new wireless weight scale (the Fitbug Wow) for $80 and a blood pressure tracker (the Fitbug Luv). None of the new gear is shipping yet, but should all be on the market before summer.

UPDATE: 2012-01-08

While Fitbug has one of the most in-your-face pitches to corporate health device buyers, they’re not the only ones talking to this market. Waaaaaayyy at the bottom of the Fitbit site is a link called Corporate Wellness that takes you to a page pitching the same concept: buy tons of our devices for employees and use them to promote wellness / drive down insurance costs. Sorry I failed to notice that one! If you have other examples from device makers, please let me know.