Section1.2Adopt – Plan

Section 1.2 Adopt – Plan –Clinical IT Leadership-1

Clinical IT Leadership

Health information technology (HIT) projects demand leadership from all clinicians, as these tools impact care delivery. While management and administrative/financial staff play key roles, many health care organizations make the mistake of viewing HIT projects as only “IT projects.” This perspective may work when implementing administrative and financial systems, but as HIT more directly impacts clinical users, the systems become clinical tools rather than IT tools. Recognize that end users, those who will be directly impacted by HIT, must play a lead role in planning.Use this tool to plan for clinical leadership—an important factor for successful HIT implementation.

Physician Roles in HIT

Many physicians are interested in becoming more directly involved in HIT and especially electronic health record(EHR) systems. Their role is less project manager, and more champion. Physicians rarely focus on the detailed management of project steps required of a project manager.

Somephysicians interested in HIT become chief medical informatics officers (CMIO) or medical directors of information systems (MDIS). Sometimes these titles are considered synonymous. In large organizations, the CMIO position is considered an officer position and part of executive leadership. Depending on the size and type of organization, physician leadership in HIT may consume from 20 to 80 percent time of a physician’s time. Some physicians volunteer such services when they can be performed outside of normal work hours; someare moderately compensated (sometimes only with token compensation), and others are compensated commensurate with either their past revenue production or equivalent to physicians who serve in other staff roles.

Not every physician will make a good a CMIO or MDIS. The individual needs skills with a strong focus on people, policy, and process. Candidates for this position may include physicians who are already engaged in quality initiatives or who have taken a special interest in EHR systems, though not becoming information technologists. In this tool, CMIO and MDIS are treated as equivalents.

CMIO/MDIS Job Description

Position: Chief Medical Informatics Officer/Medical Director of Information Systems

Reports to: ______

Summary: The CMIO coordinates activities of HIT projects with all members of the organization’s medical staff and lends advice and counsel to the organization on matters relating to physician interest in HIT. The CMIO may have responsibility for chairing applicable Domain Teams as selection and implementation of information systems progress and for maintenance of clinical efficacy on an ongoing basis.

Key Functions and Responsibilities:

  1. Solicits broad-based input from HIT projects which the organization is undertaking
  2. Engages physicians and others to help develop and use HIT
  3. Reviews medical informatics trends to spur adoption of HIT
  1. Works in concert with IT staff
  2. Leads design and modification of clinical pathways and decision support domain teams
  3. Participates in development of solutions that evaluate clinical outcomes
  1. Designs and evaluates data collection for clinical purposes
  2. Leads development of clinical documentation user interfaces
  1. Participates in patient care, assessment, and research

10.Participates in research relative to clinical information systems

Skills/Experience Required:

•Interpersonal skills, consensus builder, approachable, team player

•Collaborative management style

•Creative, good presentation skills

•Grasp of clinical work flow, systems thinker

•Interest in clinical information systems and outcomes measurement

•Flexible, mature sense of priorities

•Solid practical experience

•Politically savvy

•High tolerance for ambiguity

•Contemporary clinician

Nurse and Other Clinician Roles in HIT

Nurses and other clinicians play key roles in all elements of HIT strategic planning, selection, implementation, and use. Many nurses and clinicians are not only interested in informatics, but some may be studying nursing informatics or health informatics. Even if you do not have such trained clinical staff, or if you sense resistance from clinical staff, nurses and clinicians must become involved in the planning process. Involvement in the planning process:

•Helps educate clinicians as to what is possible with the HIT

•Aids in understanding how HIT can help their work

•Ensures that proper attention has been given to workflow and process improvement to ensure patient safety and quality of care

•Begins the change management process, where the clinicians build desire for HIT

•Sets expectations for success—no one wants to be a part of a failed project

While small health care delivery organizations may not have the ability to hire a nurse informaticist or health informaticist for the sole purpose of supporting HIT, the chief nursing officer (CNO) frequently assumes this role. The following guidance should be followed to ensure that nurses and other clinicians play key roles in the HIT projects:

□Ensure that the HIT steering committee includes representation from at least one physician, one nurse, and one other clinician (e.g., pharmacist, especially when focusing on medication management automation; laboratory worker; therapist). The health information management (HIM) professional in the organization, if not tasked to be the project manager, should be actively engaged. The HIM professional is the official custodian of the medical record and the individual most responsible for documentation management—roles which must carry over into the electronic world.

□Recognize the importance of clinician involvement in HIT by providing some form of release time, overtime, or recognition for clinician contributions. These efforts will pay back immensely in achieving success with the HIT.

□Provide adequate training for clinicians who will be part of the HIT steering committee. These individuals may need more in-depth understanding of HIT, workflow and process improvement techniques, data management, and other elements of HIT implementation. You may need to send some of these clinicians on site visits or to trade shows where HIT is demonstrated.

□Provide adequate training for all clinicians. Many end users will need to learn basic computer skills. They also need to understand what HIT is all about and how it will impact them. Webinars can be effective ways to gain understanding of HIT. Webinars can be effective in early education, the selection process, and after selection for orientation. Vendors will conduct the Webinars once the organization is actively engaged in the selection process. Before then, you will need to managethem.The effort is well worth the result.

Other Roles in HIT

Administrative/financial staff plays key roles in elements of HIT strategic planning, selection, implementation, and use. Their support and direction is invaluable.

Additional Resources

A number of professional membership and other organizations provide excellent resources, such as a body of knowledge, distance learning programs, Webinars, and listservs, for HIT planning. The following organizations provide a start for your exploration.

•American Health Information Management Association

•American Medical Informatics Association

•American Nursing Informatics Association

•Association of Medical Directors of Information Systems

•Healthcare Information Management and Systems Society (HIMSS)

Copyright © 2009, Margret\A Consulting, LLC. Used with permission of author.

For support using the toolkit

Stratis Health Health Information Technology Services

952-854-3306 

Section 1.2 Adopt – Plan – Clinical IT Leadership- 1