Clinical Informatics Leadership: A Profound Discussion ... · Mark D. Sugrue, MSN, RN-BC, FHIMSS,...

Clinical Informatics Leadership: A Profound Discussion

March 1, 2015

Carol Steltenkamp, MD, MBA, FAAP, FHIMSS, CMIO, University of Kentucky Healthcare; Executive Director, Kentucky Regional Extension Center

Mark D. Sugrue, MSN, RN-BC, FHIMSS, CPHIMS, Chief Nursing Informatics Officer, Lahey Hospital & Medical Center

Conflict of Interest

Carol Steltenkamp, MD, MBA, FAAP, FHIMSS and Mark D. Sugrue, MSN, RN-BC, FHIMSS, CPHIMS Have no real or apparent conflicts of interest to report.

Learning Objectives • Evaluate the impact of interdisciplinary informatics leadership on the healthcare environment.

• Discuss the expanding role of clinical informatics and its role in influencing health policy to improve safety and efficiency

• Describe the move from clinical informatics 1.0 to 2.0 and what the next phase of informatics may look like.

Introducing our Panelists

Carol Steltenkamp

My Informatics Journey “That it will ever come into general use, notwithstanding its value, is extremely doubtful because its beneficial application requires much time and gives a good bit of trouble, both to the patient and to the practitioner because its hue and character are foreign and opposed to all our habits and associations.”

from The London Times in 1934 Commenting on …

• 825 beds; 2 campuses • 40,000 Discharges 2015 (CMI 1.92) • 102,000 ED visits 2015, Level I

Trauma Center • 500,000 Clinic Visits 2015 • Centers of Excellence in Cardiology,

Oncology, and Neurosciences • Kentucky Children’s Hospital - Level

III NICU • NCI Designated Cancer Center • 80 specialized clinics, 150 outreach

programs

Mark Sugrue

My Informatics Journey…….

$160M Electronic Health Record Investment 2013

Facilitated Discussion

Describe the impact of interdisciplinary interprofessional informatics leadership on the healthcare environment.

Some profound questions?

• What is a CxIO • Who do you report to? • So you “used to be” a ……. • What do you DO?

http://www.himss.org/ValueSuite

HIMSS - Realizing the Value of Health IT

1.9% 4.8%

10.1% 8.1% 4.2% 6.5% 7.9% 9.7% 0.4%

1.7%

6.2% 10.0%

6.4% 6.4%

12.8%

30.1%

0%

10%

20%

30%

40%

50%

Stage 0 Stage 1 Stage 2 Stage 3 Stage 4 Stage 5 Stage 6 Stage 7

All h

ospi

tals

with

in ea

ch E

MRAM

Sta

ge

3 or less 4 or more

Representation of TJC Top Performing Hospitals BY Number of Quality Metrics Excelling In, within each EMRAM Stage

Source: HIMSS Analytics

2.3% 6.5%

16.3% 18.1%

10.6% 12.9%

20.7%

39.8%

Financial Performance (Profitability)

1.62%

2.84%

2.25%

2.35%

3.53% 4.06% 3.91%

-1.52%

-0.58%

0.77% 1.79% 1.47%

2.55%

2.20%

4.91%

-0.43% -0.34%

1.53%

2.56% 2.32%

1.66%

2.52%

6.19%

-2.0%

-1.0%

0.0%

1.0%

2.0%

3.0%

4.0%

5.0%

6.0%

7.0%

Stage 0 Stage 1 Stage 2 Stage 3 Stage 4 Stage 5 Stage 6 Stage 7

Aver

age

Ope

ratin

g M

argi

n

In 2008 In 2011 2013

Source: HIMSS Analytics

Discuss the expanding role of clinical informatics and its role in influencing health policy to improve safety and efficiency

Medicare and CHIP Reauthorization Act (MACRA)

• Replacing the Sustainable Growth Rate formula in 2017

• Focus more on quality reporting • Drive toward improvements to information-

supported clinical decision making

Precision Medicine Initiative/Research and Development

• Data-driven initiatives that will rely on the data and data analytics to advance healthcare delivery

• Personalized medicine and research solutions will capture A LOT of data that needs to be analyzed

• All comes back to clean and useful data to support healthcare transformation

Early Clinical Informatics Leadership

Data to Wisdom Continuum (Nelson)

Data Naming collecting

organizing

Knowledge Interpreting, Integrating

Understanding

Wisdom Understanding, applying,

Applying with Compassion

Information Organizing, Interpreting

Increasing Interactions and Interrelationships

Incr

easi

ng C

ompl

exity

US HEALTHCARE TRANSFORMATION PROGRESS

2006

20.4% 17.4%

40.0%

18.7%

3.1% 0.5% 0.1% 0.0%

0 1 2 3 4 5 6 7EMRAM Stage

19.3%

14.0%

37.2%

25.1%

2.2% 1.4% 0.8% 0.0%

0 1 2 3 4 5 6 7EMRAM Stage

2007

15.6% 11.5%

31.4% 35.7%

2.5% 2.5% 0.5% 0.3%

0 1 2 3 4 5 6 7EMRAM Stage

2008

11.5% 7.2%

16.9%

7.4% 3.8%

1.6% 0.7%

0 1 2 3 4 5 6 7EMRAM Stage

50.9%

2009

10.1% 7.1%

14.6% 10.5%

4.5% 3.2% 1.0%

0 1 2 3 4 5 6 7EMRAM Stage

2010

49.0%

9.0% 5.7%

12.4%

44.9%

13.2% 8.4%

5.2% 1.2%

0 1 2 3 4 5 6 7EMRAM Stage

2011

8.4% 4.3%

10.7%

38.3%

14.2% 14.0%

8.2%

1.9%

0 1 2 3 4 5 6 7EMRAM Stage

2012

5.8% 3.3%

7.6%

30.3%

15.5%

22.0%

12.5%

2.9%

0 1 2 3 4 5 6 7EMRAM Stage

2013

3.8% 2.0% 5.1%

21.0%

14.0%

32.7%

17.9%

3.6%

0 1 2 3 4 5 6 7EMRAM Stage

2014

3.1% 1.8% 3.4%

17.3%

10.3%

34.6%

25.4%

4.1%

0 1 2 3 4 5 6 7EMRAM Stage

Q3 2015

EHR = Big Data?.... I Don’t Think So !!

• So if the average length of stay in a hospital is 4.8 Days

The other 360.2 Days !! 98.69%

Our EHR Data !!! 1.31%

One Year in the Life of our Patients……..

Describe the move from clinical informatics 1.0 to 2.0 and what the next phase of informatics may look like.

1.0 2.0

Adopted from Gartner Hype Cycle http://www.gartner.com/technology/research/methodologies/hype-cycle.jsp

Regulatory changes

Advances in

technology

Implementation

Stabilization

Optimization

Realization

When is the TRANSFORMATION

going to occur?

Continuity of Care Maturity Model

HIMSS Resources HIMSS Nursing Informatics Community The nursing Informatics webinar series targets key hot topics and emerging trends in regards to health information technology and informatics http://www.himss.org/nursing HIMSS Physician Community Physician Community members contribute to advocacy efforts, participate in education offerings, grow their own professional development, access practical tools and participate in networking opportunities. http://www.himss.org/get-involved/community/physician HIMSS Clinical Informatics Insights A source for timely and comprehensive articles on effective integration of informatics across the continuum of care. http://www.himss.org/clinical-informatics-insight HIMSS Value Suite The HIMSS Health IT Value Suite highlights hundreds of examples of hospitals, physician practices, communities and accountable care organizations that have realized the full value of Health IT. http://www.himss.org/valuesuite

Questions Carol Steltenkamp – steltenkamp@uky.edu

Mark D. Sugrue - mark.d.sugrue@lahey.org