The Role of Clinical Informatics in Technology Projects

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My past two posts have focused on how technology implementations are complex collaborative experiences that require the use of a cross functional teams. Each team member brings expertise and experience from their area of focus. The Chief Nursing Informatics Officer (or a Clinical Informaticist) is emerging as a key contributor in complex collaborative technology projects.  While the role of the CNIO varies from hospital to hospital, we have found that their presence is critically important to the success of a project.

The Informatics Team bridges the gap between IT and nursing by creating opportunities for conversations to occur about clinical workflow and technology application.   They are trained to understand how people, process, and technology intersect. They are masters of the of question “Why” and determining “How” technology will compliment or hinder future state. Many launched their role in informatics implementing the EHR at their hospital. They are intimately familiar with how the clinical environment operates and uniquely prepared to contribute to new technology selection and implementation teams. Their experience allows them to quickly understand how new technology will affect the current state and how it may enhance or detract from current outcomes.

The CNIO and his/her team must advocate for the clinician and translate the value proposition to the users. Their ability to advocate can make or break the adoption of technology in the clinical environment. They are collaborators, advocators, and enablers of the future of nursing.  I loved this quote from the CNO of Burwood Group, Kathleen Harmon.

“When working towards a strategy for future care delivery, it’s essential to consider people, process and technology – and order matters! We must first understand current state workflow through observing bedside caregivers and aligning that to future care deliver needs, identifying areas where process changes are required to optimize workflow and ensuring caregivers are supported to deliver high quality, safe, and efficient care. Then, and only then, we should look to technology to enable care delivery. If we consider technology too soon in the process, fragmented and point solutions are common, leading to greater chaos at the point of care. Simply put, technology must support workflow and workflow must enable the caregiver to be at his/her best.”

Once the project is implemented the informatics team will be responsible for measuring how the technology helps (or does not help) the team reach the desired outcomes. Their unique training makes them capable of owning the measurement (and associated tools) and delivering information to the executive team on the enhancements gained from the new technology. However, this task will require the ability to aggregate, validate, and disseminate information from multiple applications to ascertain values gain. We encourage your team to walk through the workflow from start to report (data).

We find that many hospitals stop at workflow. They identify the features and functionalities that will enhance their current state, but stop short of evaluating the data. Not just the reports – the actual data that is compiled for storage and leveraged for interoperability. Does the vendor believe in open sharing of their data for aggregation and integration with other tools? A single system that lives in a vacuum will not serve you well over the long run. The technology you are acquiring is a tool and every tool – whether software or hardware, provides transactional information from their electronics or software. The raw data should never be considered proprietary.

Kelly Aldrich, DNP, RN-BC, CCRN-A, RYT is the Chief Clinical Transformation Officer for Center of Medical Interoperability. During the Nursing Informatics Symposium, she made an outstanding statement

“If we want to change healthcare, we all have to get on board with data liquidity.”

She went on to describe how many hospitals are held hostage as technology vendors lock their data in proprietary data jails within their products which disables the ability for data to freely flow from one device to another. Her analogy was that interoperability should be as open and available as electricity.

The CNIO and the Informatics team should assert their position within any new technology acquisition process. Their role is critical to having a positive outcome and full adoption of technology.

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