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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
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
