Hospitals and health systems nationwide are moving rapidly to put into place teams of clinical informaticists in order to move forward on meaningful use under the ARRA-HITECH Act. But, say clinical informaticists and CIOs at pioneering hospital organizations, it takes years to develop the kinds of synergy that will be needed to achieve the kinds of optimization of clinical IT that organizations are hoping for.
Clinical informaticists and others interviewed for this article urge CIOs to consider the collaborative nature of successful models for building clinical informaticist teams, as well as the broad range of skill sets and personal characteristics that will be needed to make individual clinical informaticists successful. But time is of the essence, and the shortages of qualified candidates can only be expected to intensify dramatically in the next few years.
Is it high time for your organization to move forward to achieve meaningful use under the requirements of the federal American Reinvestment and Recovery Act/Health Information Technology for Economic and Clinical Health (ARRA-HITECH) Act? Do you need to finally begin implementing computerized physician order entry (CPOE) enterprise-wide? Are you moving forward on physician and nursing documentation? On implementing your electronic medication administration record (eMAR)? On quality data reporting? How about your readmissions analysis? If you said “yes” to any of the above, you've probably already realized that having an energized, in-sync, multidisciplinary team of clinical informaticists will be essential to your success. And you wouldn't be alone.
In fact, nationwide, the clinical informaticist team phenomenon is surging as never before, as CIOs and other senior leaders in hospitals and health systems come to recognize the need for physicians, nurses and pharmacists with some level of informatics experience as a key nexus element in their clinical IT strategies. Not surprisingly, patient care organizations and recruiters are reporting tremendous shortages of qualified people nationwide, especially those who have had previous experience with electronic medical record (EMR), CPOE, eMAR, advanced pharmacy and other clinical implementations. Indeed, industry experts expect the shortages to become more and more severe as the meaningful use train moves forward.
Even more importantly, say CIOs and other leaders, the creation, nurturance and collaboration of these teams of clinical informaticists will be as vital to success with all things clinical IT as any other element. And those organizations with some experience under their collective belts emphasize that it has taken them years to get to where they are now. In other words, if you haven't started building your clinical informatics team, you'Re already starting the race at the back of the pack. Consider the following:
At the 20-hospital University of Pittsburgh Medical Center (UPMC) health system, a multidisciplinary team of clinical informaticists, drawn from medicine, nursing, pharmacy and other disciplines, continues to work at the system level on the organization's many rollouts, upgrades, and performance improvement initiatives. That corporate-level team has been continuously nurturing multidisciplinary clinical informaticist teams at every UPMC facility for years now, as the organization surges forward on all fronts as a national clinical IT leader.
At the 244-bed Holy Redeemer Health System, a community hospital organization based in the Philadelphia suburb of Meadowbrook, Pa., senior vice president and CIO Anne Searle has been helping to lead a large team of clinical informaticists and IT professionals forward through a period of rapid clinical IT advancement. This spring, the Holy Redeemer organization was the first CPOE customer of the Malvern, Pa.-based Siemens Healthcare to migrate from the older Siemens INVISION system to the company's newer Soarian system. Within the first week, Holy Redeemer physicians were placing 75 percent of their orders electronically through the Soarian CPOE. The amount of training involved prior to go-live was very extensive, Searle reports. And as she and her colleagues continue to forge ahead to optimize their clinical information systems, they are proving that CPOE can be successfully implemented in a community hospital setting, even in a market in which many voluntary physicians have privileges in multiple hospitals, Searle says.
At the Roanoke, Va.-based Carilion Clinic, senior vice president and CIO Daniel Barchi and Steve Morgan, M.D., the organization's vice president of clinical informatics, have helped lead the successful implementation of EMR and CPOE across the eight-hospital system, within the breakneck span of 18 months from the initial steps taken at the flagship, 880-bed Carilion Medical Center, to the final go-live, which took place last month. Barchi and Morgan have also been leading EMR rollout across 125 of 140 affiliated physician clinics to date.
In southeast Florida, Christi Rushnell and James Shaffer, M.D., have been crafting an EMR implementation strategy that is strongly physician champion-based. Rushnell, vice president of information technology at the three-hospital HealthFirst Inc. system based in Rockledge, and Shaffer, the medical director of the health system's electronic intensive care unit (eICU), have been focusing on phasing in physician and nursing documentation and CPOE over time and across their organization's three facilities (set to become four next year). In addition, because most physicians in South Brevard County are already live on some form of EMR, Rushnell says her team's strategy will emphasize the health information exchange (HIE) aspects of data-sharing and computing.