Michelle Woodley, Chief Nursing Information Officer, St. Joseph Health
Clinical Informatics was first designated as a nursing specialty by the American Nurses Association (ANA) in 1992 and Clinical Informatics was approved by the American Board of Medical Specialty (ABMS) as a certified medical subspecialty in 2011. Since that time, the focus of informaticists has been on the implementation, support and optimization of electronic health records across the United States spurred by meaningful use and the Medicare and Medicaid Electronic Health Record (EHR) Incentive Program. However, many do not understand what these professionals do in their practice and their full future impact. Informaticists blend their clinical knowledge, experience and expert understanding of clinical workflow with information management and analytical sciences. They bridge the science and art of care with the exciting world of technology bringing both skill in their areas of practice and a keen aptitude in information technology. Coupled with the promise of predictive analytics, precision medicine and other advanced technologies, this distinctively skilled group is uniquely poised to dramatically impact individual care as well as population outcomes, uncover major cost saving opportunities and give back time to the bedside care providers who have long been burdened with entering copious amounts of data often without significant benefit.
Many industries have already been harnessing the power of predictive analytics. The airline industry uses predictive analytics in determining consumer purchasing patterns and real time pricing. Shipping and logistic workers can optimize delivery times using predictive analytics to determine best shipping routes, timing and carriers. Oil and gas companies use analytics to determine the best potential for drilling locations. What all of these have in common is large amounts of diverse data that must be interpreted relationally to each other. The human mind is uniquely equipped to assess and critically think but computers are best leveraged to learn patterns across large amounts of data that the human mind could not consume and display in actionable context. Computers cannot alone interpret or understand the intricacies of the human body and disease nor determine where best in the workflow to make the valuable information available. But combined, the human mind, science and caring touch coupled with technology holds endless potential and informatics stands at the crossroads of this vital work.
"Informaticists stand ready to partner with advanced technologies to directly impact and transform care"
Unfortunately, healthcare like all industries is faced with the reality of limited resources. Care providers are faced with an ever growing amount of regulatory regulations and financial pressures which drive the gathering of more and more data. Little progress has been made in taking this data and turning it into useful information delivered at the point of clinical decision and giving back valuable time to physicians and clinicians in their day. While efforts have been made to collect and collate large amounts of data, this is often inaccessible to the care providers in a way that can be easily used in the course of their efforts. As such, the promise of predictive analytics will not be realized unless those predictions are woven back into the workflow of where clinicians practice. Simply providing data in reports will fall short with the potential to go unread or reveal information too late. The key is to provide information to the right person, at the right time in the right way to impact care and make a difference.
Imagine being able to compute large amounts of valuable data about individuals not just their electronic health records but in relationship to other data such as socioeconomic status, buying patterns, compliance with filling prescriptions, education, household and community demographics and whether their unique genomics will respond to a particular medicine. Imagine being able to answer questions based on an individual’s unique set of relational data as to who is at greatest risk of a heart attack, being readmitted, developing diabetes, going septic, developing a pressure ulcer and the list goes on and on. Imagine being able to focus valuable resources on those identified individuals versus large unspecified risk pools. But simply being able to make those specific predictions will not necessarily result in changes in care and outcomes or cost avoidance unless the information is put back into the direct workflow of those who can impact change. Fortunately, the day where these kinds of predictive tools are available to us is here. But it will take informaticists skilled in understanding how best to incorporate these exciting technologies into the workflow to reap the full value. Oprah Winfrey once said “I've come to believe that each of us has a personal calling that's as unique as a fingerprint—and that the best way to succeed is to discover what you love and then find a way to offer it to others in the form of service, working hard, and also allowing the energy of the universe to lead you.” Being an informaticist is truly a calling. Informaticists stand ready to partner with advanced technologies to directly impact and transform care and finally deliver on the promise of useful data in healthcare.
Hesham Abboud, MD, PhD, Director of the Multiple Sclerosis and Neuroimmunology Program and staff neurologist at the Parkinson’s and Movement Disorder Center at University Hospitals of Cleveland, Case Western Reserve University School of Medicine