Management Engineering & Process Improvement Community

June 5, 2015

Cynthia Hartmann, MBA, CPHIMS, Six Sigma Lean Black Belt

Committee Chair

MEPI COMMUNITY MISSION

Support and promote the profession of management engineering and process improvement among the members of HIMSS by providing opportunities for networking, collaboration, publication, promotion and professional development of Management Engineers and Process Improvement professionals in healthcare organizations.

The Evolving Role of Informatics; Process as a key

Informatics Competency Denise Hammel, RN-BC, MSN, CLSSBB, CMQ/OE

Agenda

• This presentation will:

• Describe the competencies of Informatics professionals

• Highlight the major trends in healthcare and the need for specialized skills

• Determine where skills and the ability to build certain skills exist

• Provide recommendations for how Informatics professionals can be leveraged to fulfill an emerging need

Informatics Defined

• Nursing informatics (NI) is the specialty that integrates nursing science with multiple information management and analytical sciences to identify, define, manage, and communicate data, information, knowledge, and wisdom in nursing practice. NI supports nurses, consumers, patients, the interprofessional healthcare team, and other stakeholders in their decision-making in all roles and settings to achieve desired outcomes. This support is accomplished through the use of information structures, information processes, and information technology. Nursing Informatics: Scope and Standards of Practice, 2nd edition ANA 2015

HIMSS, 2015 The Impact of Informatics Workforce Slides

Informatics Competencies

51% 57%

61% 64% 65% 66% 67% 67%

70% 71%

75% 76%

80%

Integration/Interface with Other Systems

Reporting

Reduction of Never Events

Quality Outcomes

Completeness of Documentation

Screenflow

Definition of Alerts/Reminders

Accuracy of Documentation

Compliance with Policies/Regulations

Design/Configuration

User Acceptance

Patient Safety

Workflow

Areas Where Informatics Nurses Bring a High Degree of Value

HIMSS 2015 Nursing Workforce Survey

Titles tend to reflect individual, organization or business unit needs or configuration; such as

human resources planning, organization, department, or

team reporting structures. Mimi Hassett, MS, RN, FHIMSS

Current Focus of Informatics

• 58% of nursing informatics professional work inside a hospital setting

• Approximately 30% of organizations support a CNIO role

• 60% of respondents indicated that having an informatics professional positively impacted care

• 85% of respondents indicated that informatics are involved with the implementation of emerging technologies

• Historical focus on storage and retrieval of data but moving towards the need for new ways of translating into knowledge

“Together, nurses and nursing informatics must lead, and be visible, vocal and present at the table to achieve healthcare delivery transformation.”

HIMSS Future of Nursing Campaign

ME/PI Survey

• From the ME/PI survey this year, the question “ What is the biggest challenge you expect in 2015 for ME-PI Professionals”

• The top four themes are:

• Ambulatory care

• Data use

• Process + technology

• Population health and the coordination of care

Top 10 Applications Currently Being Installed

14%

14%

15%

17%

18%

18%

20%

23%

26%

27%

Personal Health Record

Quality Improvement

Point of Care Clinical Decision Support

Immunization Information Systems

Remote Monitoring/Telehealth

Electronic Prescribing

Voice Recognition

Medical Device Integration

Mobile Applications

Health Information Exchange

HIMSS 2015 Impact of Informatics Survey

50 to 60% of CEO’s are concerned they don’t have the appropriate skill sets to execute the strategy they create….

Industry Gaps

• Some projections suggest a 20% jump in technology jobs by 2018 with some of these jobs requiring a strong informatics skill set

• As technology becomes more consumer (patient) centric, it will need greater usability (human factors) in its design

• An increase in mobile solutions, including RTLS for improved efficiency and cost savings will require strong process redesign

• Informatics resources as a central role to redesigning patient flow and data collection to support coordinated care and population health related activities

• Informatics to position the advancement of technology in long term care, skilled care and home (hospital at home) settings with the knowledge of how patients flow through these areas

• Tools on the CDC website to help facilitate HIE, public health reporting highlight the need to possess data flow and process knowledge

Emerging Focus of Informatics

• Almost 60% of organizations are interested in implementing mobile technology

• About 50% of organizations will be pursuing Health Information Exchanges

• Only 17% of Long term care, skilled care facilities have EHR technology, a number which is expected to rapidly grow

Building Bridges to the Future

• Shift the focus of Informatics away from traditional activities inside the organization to activities outside the organization

• Combining Informatics with a strong process improvement focus enables care coordination activities

• Population health data sets can be improved by using informacist who possess a deep understanding of data at it’s root

• HIE’s can be transformed from paths that move data to workflow-enabled care redesign

“Care coordination is foundational to the healthcare care reform goals of improving the quality of care for individuals and populations via the efficient and effective use of resources.”

Do we have well-developed skills to manage this?

Informatics Lead Coordinated Care Workflow

• More granularly distinguishes workflow steps • Captures more meaningful time-stamped task data • More actively influences point-of-care workflow • Helps model and understand workflow • Better coordinates patient care task handoffs • Monitors patient care task execution in real-time • Systematically improves workflow effectiveness & efficiency

iHealthtran.com

Why not Lean Informatics?

Social Technical Analysis Theory

• While more research is needed, Social Technical Analysis theory show promise for addressing:

• Workload issues

• Medical device integration

• Transitions in care and patient-centered care

• Patient safety and risk management

Enablers for Success

• Key metrics to measure our efforts in process improvement

• Improve communication during transitions between providers, patients, family caregivers and community supports

• Develop standardized processes for medication reconciliation and care coordination

• Develop performance measures to encourage better transitions of care

Key Recommendations for Practice • Provide opportunities for informatics professionals to take a leading role in

transformational efforts • Align departments and functions to maximize the strengths and resources for each

area • Create leadership pathways for Informatics professional to take a greater role in

the: • Identification of key focus areas of improvement

• Selection of the best strategy

• Oversight and accountability to change macro-processes and improve outcomes

References Carayon, P., Bass, E., Bellinandi, T., Gurses, A., & Hallbeck, S. (2011). Socio-Technical Systems Analysis in Health Care: A Research Agenda. IIE Trans Healthc Syst Eng, 1(1), 145-160. Cernik, B. (1999). The Future of Healthcare Informatics . International Journal of Medical Informatics , 83-85. Hassett, MS, RN, FHIMSS, M. (2015). Case Study: Factors in Defining the Nurse Informatics Specialist Role. Journal of Healthcare Information Management, 20(2), 30-35. Murphy, RN, FACMI, FHIMSS, J. (2011). The nursing informatics workforce: who are they and what do they do? Nursing Economics, 29(3), 150-152. Pizzi, R. (2014, February 23). Nursing Informatics Adds Value as Healthcare is Transforming . Retrieved from Healthcare IT News: www.healthcareitnews.com

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